{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T06:56:40Z","timestamp":1775026600157,"version":"3.50.1"},"reference-count":23,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100017959","name":"Health Commission of Hebei Province","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100017959","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:p>\n                    Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of malignant lymphoma in adults. According to the gene expression profile, it can be classified into germinal center B-cell (GCB) type and activated B-cell (ABC) type. Cases with coexistence of the two subtypes and cross-site involvement are extremely rare. Herein, we report a 65-year-old female patient who presented with blurred vision in the right eye. Imaging examinations revealed space-occupying lesions in the left thalamus, basal ganglia, deep temporal lobe and left temporal muscle. Pathological biopsy and immunohistochemistry confirmed that the intracranial lesion was ABC subtype DLBCL and the temporal muscle lesion was GCB subtype DLBCL. Fluorescence\n                    <jats:italic>in situ<\/jats:italic>\n                    hybridization (FISH) excluded c-MYC, Bcl-2 and Bcl-6 gene rearrangements. No involvement of other sites was detected by PET-CT and bone marrow biopsy. The patient initially received 2 cycles of rituximab combined with high-dose methotrexate chemotherapy. Efficacy evaluation showed stable disease (SD) of the intracranial lesion and complete response (CR) of the temporal muscle lesion. Subsequently, the regimen was adjusted to 6 cycles of cytarabine combined with temozolomide chemotherapy followed by radiotherapy for the intracranial lesion. Eventually, the intracranial lesion achieved partial response (PR) and the temporal muscle lesion maintained sustained CR. Up to the date of follow-up, the patient\u2019s condition was stable without recurrence. Combined with literature review, this article discusses the possible mechanisms of the coexistence of dual-subtype DLBCL (clonal evolution or biclonal origin), the potential pathways of temporal muscle metastasis and the impact of subtype differences on treatment response, which provides clinical reference for the diagnosis and individualized treatment of such rare cases.\n                  <\/jats:p>","DOI":"10.3389\/fonc.2026.1802521","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T05:01:37Z","timestamp":1775019697000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["A case report and literature review of rare intracranial and extracranial dual-lesion diffuse large B-cell lymphoma with heterogeneous subtypes (GCB type + ABC type)"],"prefix":"10.3389","volume":"16","author":[{"given":"Yadong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Oncology, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xuejuan","family":"Duan","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jinlong","family":"Liu","sequence":"additional","affiliation":[{"name":"Graduate School, Hebei North University","place":["Zhangjiakou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shaoning","family":"Yin","sequence":"additional","affiliation":[{"name":"Department of Hematology, Fourth Hospital of Hebei Medical University","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gang","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Meijian","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xianbo","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Oncology, Hebei General Hospital","place":["Shijiazhuang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,1]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s13550-023-01047-5","article-title":"Baseline 18F-FDG PET\/CT radiomics for prognosis prediction in diffuse large B cell lymphoma","volume":"13","author":"Jing","year":"2023","journal-title":"EJNMMI Res"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2023.11.006","article-title":"Biological heterogeneity in diffuse large B-cell lymphoma","volume":"60","author":"Hilton","year":"2023","journal-title":"Semin Hematol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.3389\/fmolb.2023.1124360","article-title":"Molecular classification and therapeutics in diffuse large B-cell lymphoma","volume":"10","author":"Shimkus","year":"2023","journal-title":"Front Mol Biosci"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1158\/2643-3230.BCD-24-0020","article-title":"Repurposing NAMPT inhibitors for germinal center B cell-like diffuse large B-cell lymphoma","volume":"5","author":"Scuoppo","year":"2024","journal-title":"Blood Cancer Discov"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.75560","article-title":"Hypothermia, hallucinations, and atrial fibrillation secondary to diffuse large B-cell lymphoma","volume":"16","author":"Celebi","year":"2024","journal-title":"Cureus"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1080\/10428194.2025.2458214","article-title":"CAR-T cell therapy in the treatment of relapsed or refractory primary central nervous system lymphoma: recent advances and challenges","volume":"66","author":"Xiong","year":"2025","journal-title":"Leuk Lymphoma"},{"key":"B7","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1016\/j.clml.2023.01.003","article-title":"Whole-exome sequencing revealed the mutational profiles of primary central nervous system lymphoma","volume":"23","author":"Zhang","year":"2023","journal-title":"Clin Lymphoma Myeloma Leuk"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1053\/j.seminhematol.2023.11.004","article-title":"Epidemiology and etiology of diffuse large B-cell lymphoma","volume":"60","author":"Wang","year":"2023","journal-title":"Semin Hematol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1007\/s00428-023-03516-7","article-title":"Prevalence of IRF4 rearrangement in large B-cell lymphomas of the Waldeyer's ring in adults","volume":"482","author":"Streich","year":"2023","journal-title":"Virchows Arch"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2023.1224733","article-title":"Clinicopathological analysis of diffuse large B-cell lymphoma using molecular biomarkers: a retrospective analysis from 7 Hungarian centers","volume":"13","author":"Balik\u00f3","year":"2023","journal-title":"Front Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1002\/gcc.23211","article-title":"Alternative genetic alterations of MYC, BCL2, and\/or BCL6 in high-grade B-cell lymphoma (HGBL) and diffuse large B-cell lymphoma (DLBCL): Can we identify different prognostic subgroups","volume":"63","author":"Blomme","year":"2024","journal-title":"Genes Chromosomes Cancer"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.4274\/tjh.galenos.2023.2023.0110","article-title":"Value of GCET1, HGAL (GCET2), and LMO2 in the determination of germinal center phenotype in diffuse large B-cell lymphoma","volume":"40","author":"Berker","year":"2023","journal-title":"Turk J Haematol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2023.1288110","article-title":"Modeling the crosstalk between Malignant B cells and their microenvironment in B-cell lymphomas: challenges and opportunities","volume":"14","author":"Brauge","year":"2023","journal-title":"Front Immunol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"408","DOI":"10.3892\/ol.2023.13994","article-title":"Unusual localization and clinical presentation of primary central nervous system extranodal marginal zone B-cell lymphoma: a case report","volume":"26","author":"Fiorentino","year":"2023","journal-title":"Oncol Lett"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.1667","article-title":"Emerging findings into molecular mechanism of brain metastasis","volume":"7","author":"Ni","year":"2018","journal-title":"Cancer Med"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1248\/bpb.b21-00463","article-title":"Proteomics analysis of lymphatic metastasis-related proteins using highly metastatic human melanoma cells originated by sequential in vivo implantation","volume":"44","author":"Chida","year":"2021","journal-title":"Biol Pharm Bull"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1158\/2643-3230.BCD-24-0020","article-title":"Repurposing NAMPT inhibitors for germinal center B cell-like diffuse large B-cell lymphoma","volume":"5","author":"Scuoppo","year":"2024","journal-title":"Blood Cancer Discov"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1002\/cbdv.202401533","article-title":"Single and combinatorial effects of metformin and thymoquinone in diffuse large B cell lymphoma cells","volume":"22","author":"Glamo\u010dlija","year":"2025","journal-title":"Chem Biodivers"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.81476","article-title":"A natural course from primary intraocular lymphoma to brain lymphoma in four years according to patient's choice","volume":"17","author":"Matsuo","year":"2025","journal-title":"Cureus"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3390\/curroncol30120764","article-title":"Ibrutinib plus RCHOP versus RCHOP only in young patients with activated B-cell-like diffuse large B-cell lymphoma (ABC-DLBCL): a cost-effectiveness analysis","volume":"30","author":"Rho","year":"2023","journal-title":"Curr Oncol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.62031","article-title":"Prognostic significance of Bcl-2 expression in non-germinal center B-cell-like diffuse large B-cell lymphoma","volume":"16","author":"Alford","year":"2024","journal-title":"Cureus"},{"key":"B22","doi-asserted-by":"publisher","first-page":"433","DOI":"10.3892\/ol.2025.15179","article-title":"Morphological, immunophenotypic and neuroradiological characteristics of primitive B-large cell diffuse lymphoma of the central nervous system: a retrospective cohort analysis","volume":"30","author":"Rizzuto","year":"2025","journal-title":"Oncol Lett"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1182\/blood.2020008377","article-title":"Primary central nervous system lymphoma","volume":"140","author":"Schaff","year":"2022","journal-title":"Blood"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1802521\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T05:01:39Z","timestamp":1775019699000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1802521\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,1]]},"references-count":23,"alternative-id":["10.3389\/fonc.2026.1802521"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1802521","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,1]]},"article-number":"1802521"}}