Primary breast lymphoma (PBL) is a kind of rare primary extranodal lymphoma, which is of relatively poor prognosis and so far there is no unified treatment. In the case diagnosed by Our hospital where one patient recurring breast diffuse large B cell lymphoma (DLBCL) many times, has been treated with good therapeutic effect through surgery, chemotherapy, targeted drug therapy and radiotherapy. A multidisciplinary discussion is made concerning the treatment of the patient in this article for the purpose of further discussing the standard treatment procedure for PBL and promoting multi-disciplinary team.

Objective:To investigate the relations of clinical manifestations with sequence numbers detected in the cerebrospinal fluid of varicella-zoster virus (VZV) encephalitis/meningitis patients based on metagenomic next-generation sequencing (mNGS).Methods:Fifty-four VZV encephalitis/meningitis patients admitted to Department of Neurology, Harrison International Peace Hospital from January 2016 to October 2022 were selected. Sequence numbers of VZV in the cerebrospinal fluid of these patients were detected by mNGS; these patients were divided into low-detected sequence number group (≤1 000) and high-detected sequence number group (>1 000) accordingly. Differences in clinical manifestations, auxiliary examination results, treatments and prognoses were compared between the two groups.Results:Twenty-six patients were into low-detected sequence number group and 28 patients were into high-detected sequence number group. Compared with the low-detected sequence number group, the high-detected sequence number group had significantly older age (48.0 [35.5, 65.3] years vs. 63.0 [54.0, 71.8] years), higher proportion of patients using immunosuppressants (0.0% vs. 14.3%), lower proportion of those with meningeal irritation signs (46.2% vs. 17.9%), higher proportions of those with abnormal mental behaviors (15.4% vs. 42.9%), epilepsy (3.8% vs. 28.6%), and consciousness disorders (11.5% vs. 42.9%), greater cerebrospinal fluid pressure (150.0 [127.5, 177.5] mm H 2O vs. 185.0 [152.5, 210.0] mm H 2O), higher electroencephalogram positive rate (11.8% vs. 47.7%), and higher poor prognosis rate at discharge (26.9% vs. 66.7%, P<0.05). Conclusions:The clinical phenotype of the low-detected sequence number group tends to meningitis, while that of the high-detected sequence number group tends to encephalitis. Patients with high-detected sequence numbers have high cerebrospinal fluid pressure and abnormal electroencephalogram, enjoying poor prognosis.