Uncommon findings of primary diffuse large B-cell lymphoma of the central nervous system: Multifocal simultaneous hemorrhage.

A 60-year-old immunocompetent man presented with a 5-day history of headache. Neurological examination revealed mild disturbance of consciousness and left homonymous hemianopia. Brain CT revealed multiple hyperdense lesions, and T2*-weighted MRI showed hypointense signals indicative of intratumoral hemorrhage. FDG-PET demonstrated intense and uniform uptake across all lesions. Histopathological analysis of a biopsied lesion confirmed the diagnosis of primary diffuse large B-cell lymphoma of the central nervous system (PCNS-DLBCL). This case is notable for the rare presentation of PCNS-DLBCL with multiple hemorrhagic lesions in an immunocompetent patient. It underscores the need to consider PCNS-DLBCL in the differential diagnosis of hemorrhagic brain lesions and highlights the diagnostic utility of advanced imaging techniques.