CASE REPORT article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1636597
This article is part of the Research TopicCase Reports in Autoimmune and Autoinflammatory Disorders: Volume IIView all 17 articles
Case Report: A Case of Neuropsychiatric Lupus with Primary Central Nervous System Diffuse Large B-Cell Lymphoma
Provisionally accepted
Yuexi Zhang
Shaoling ZhengYiming LiShuyang ChenXin GuoZhixiang Huang
Weiming DengYuheng Xing
Zhengping Huang*
Tianwang Li*- Department of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China
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Background The coexistence of neuropsychiatric systemic lupus erythematosus (NPSLE) and primary diffuse large B-cell lymphoma (DLBCL) of the central nervous system (CNS) (PCNS DLBCL) is extremely rare in clinical practice. This article retrospectively analyzes the clinical manifestations, imaging examinations, pathological diagnosis, and treatment process of a patient with NPSLE, from the appearance of intracranial abnormal signal shadows to the final diagnosis of PCNS DLBCL. Case summary A 32-year-old Chinese female patient had previously visited our hospital due to vomiting and delirium and was diagnosed with NPSLE. In February 2021, she returned to our hospital with vomiting again. Laboratory tests revealed elevated infection markers and Epstein-Barr virus infection. Brain CT and MRI showed an abnormal intracranial lesion on the left side, which was initially considered to be a brain abscess. After one week of ineffective anti-infection treatment, the patient underwent surgery, during which the lesion was identified as a brain tumor and successfully resected. The final diagnosis was PCNS DLBCL. The patient improved after treatment and was discharged from the hospital. There has been no recurrence of NPSLE or lymphoma within three years. Conclusion When patients with NPSLE develop new intracranial lesions, misdiagnosis is likely to occur. Imaging and pathology are crucial, and clarifying the nature of the lesion is conducive to a good long-term prognosis.
Keywords: Neuropsychiatric Systemic Lupus Erythematosus (NPSLE), Primary diffuse large B-cell lymphoma of the central nervous system lymphoma (PCNSL), Brain Abscess, Misdiagnosis, case report
Received: 28 May 2025; Accepted: 06 Aug 2025.
Copyright: © 2025 Zhang, Zheng, Li, Chen, Guo, Huang, Deng, Xing, Huang and Li. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Zhengping Huang, Department of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China
Tianwang Li, Department of Rheumatology and Immunology, The Affiliated Guangdong Second Provincial General Hospital of Jinan University, Guangzhou, China
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