Overcoming missed diagnoses of primary central nervous system Lymphoma—The key role of cerebrospinal fluid cytology: a case report

Abstract Background Central nervous system (CNS) involvement in diffuse large B-cell lymphoma (DLBCL) is relatively rare, occurring at a rate of approximately 5%. Primary CNS lymphoma (CNS-DLBCL), a subtype of DLBCL, is rare clinically but highly malignant and invasive. Its atypical clinical symptom...

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Main Authors: Siqi Zhu, Juan Jin, Xinxin Wang, Hong Xu, Fuxian Zhou, Yuyi Lai, Daojun Yu, Yuli Zhou
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Diagnostic Pathology
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Online Access:https://doi.org/10.1186/s13000-025-01626-1
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author Siqi Zhu
Juan Jin
Xinxin Wang
Hong Xu
Fuxian Zhou
Yuyi Lai
Daojun Yu
Yuli Zhou
author_facet Siqi Zhu
Juan Jin
Xinxin Wang
Hong Xu
Fuxian Zhou
Yuyi Lai
Daojun Yu
Yuli Zhou
author_sort Siqi Zhu
collection DOAJ
description Abstract Background Central nervous system (CNS) involvement in diffuse large B-cell lymphoma (DLBCL) is relatively rare, occurring at a rate of approximately 5%. Primary CNS lymphoma (CNS-DLBCL), a subtype of DLBCL, is rare clinically but highly malignant and invasive. Its atypical clinical symptoms and imaging features contribute to a high rate of misdiagnosis and a poor prognosis. Thus, early and accurate diagnosis is imperative for improving the patient’s prognosis. Cerebrospinal fluid (CSF) cytology, a rapid and convenient diagnostic method, plays a crucial role in diagnosing intracranial tumors. Case presentation In this instance, the patient presented with nonspecific early symptoms and exhibited atypical imaging findings. A lumbar puncture performed at another hospital yielded a low cell count in the CSF, leading to an incorrect diagnosis. Upon admission to our hospital, CSF cytology identified abnormal cells. A definitive diagnosis of CNS-DLBCL was established utilizing additional diagnostic methods, facilitating targeted treatment. Conclusions This case underscores the pivotal role of CSF cytology in rapidly guiding the differential diagnosis of intracranial tumors and underscores the necessity of training laboratory personnel in morphological examination.
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spelling doaj-art-ca54bce7dfb0475f8b5ddd497c2513822025-08-20T03:01:42ZengBMCDiagnostic Pathology1746-15962025-03-012011910.1186/s13000-025-01626-1Overcoming missed diagnoses of primary central nervous system Lymphoma—The key role of cerebrospinal fluid cytology: a case reportSiqi Zhu0Juan Jin1Xinxin Wang2Hong Xu3Fuxian Zhou4Yuyi Lai5Daojun Yu6Yuli Zhou7Department of Nephrology, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine)Department of Nephrology, the First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine)Department of Laboratory Medicine, Affiliated the First People’s Hospital of Jinzhong CityDepartment of Laboratory Medicine, Affiliated Hangzhou First People’s Hospital, Westlake University School of MedicineDepartment of Laboratory Medicine, Yanbian University HospitalDepartment of Laboratory Medicine, Nanning First People’s HospitalDepartment of Laboratory Medicine, Affiliated Hangzhou First People’s Hospital, Westlake University School of MedicineDepartment of Laboratory Medicine, Affiliated Hangzhou First People’s Hospital, Westlake University School of MedicineAbstract Background Central nervous system (CNS) involvement in diffuse large B-cell lymphoma (DLBCL) is relatively rare, occurring at a rate of approximately 5%. Primary CNS lymphoma (CNS-DLBCL), a subtype of DLBCL, is rare clinically but highly malignant and invasive. Its atypical clinical symptoms and imaging features contribute to a high rate of misdiagnosis and a poor prognosis. Thus, early and accurate diagnosis is imperative for improving the patient’s prognosis. Cerebrospinal fluid (CSF) cytology, a rapid and convenient diagnostic method, plays a crucial role in diagnosing intracranial tumors. Case presentation In this instance, the patient presented with nonspecific early symptoms and exhibited atypical imaging findings. A lumbar puncture performed at another hospital yielded a low cell count in the CSF, leading to an incorrect diagnosis. Upon admission to our hospital, CSF cytology identified abnormal cells. A definitive diagnosis of CNS-DLBCL was established utilizing additional diagnostic methods, facilitating targeted treatment. Conclusions This case underscores the pivotal role of CSF cytology in rapidly guiding the differential diagnosis of intracranial tumors and underscores the necessity of training laboratory personnel in morphological examination.https://doi.org/10.1186/s13000-025-01626-1CNS DLBCLPCNSLCerebrospinal fluid morphology (CSF) cytologyIntracranial tumor
spellingShingle Siqi Zhu
Juan Jin
Xinxin Wang
Hong Xu
Fuxian Zhou
Yuyi Lai
Daojun Yu
Yuli Zhou
Overcoming missed diagnoses of primary central nervous system Lymphoma—The key role of cerebrospinal fluid cytology: a case report
Diagnostic Pathology
CNS DLBCL
PCNSL
Cerebrospinal fluid morphology (CSF) cytology
Intracranial tumor
title Overcoming missed diagnoses of primary central nervous system Lymphoma—The key role of cerebrospinal fluid cytology: a case report
title_full Overcoming missed diagnoses of primary central nervous system Lymphoma—The key role of cerebrospinal fluid cytology: a case report
title_fullStr Overcoming missed diagnoses of primary central nervous system Lymphoma—The key role of cerebrospinal fluid cytology: a case report
title_full_unstemmed Overcoming missed diagnoses of primary central nervous system Lymphoma—The key role of cerebrospinal fluid cytology: a case report
title_short Overcoming missed diagnoses of primary central nervous system Lymphoma—The key role of cerebrospinal fluid cytology: a case report
title_sort overcoming missed diagnoses of primary central nervous system lymphoma the key role of cerebrospinal fluid cytology a case report
topic CNS DLBCL
PCNSL
Cerebrospinal fluid morphology (CSF) cytology
Intracranial tumor
url https://doi.org/10.1186/s13000-025-01626-1
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