Being narcissistic doesn't seem to necessarily go with high self-esteem -- of the healthy sort we tend to think of anyway.) (I know one.) Narcissism is often cover for people with very fragile egos. It's a malignant way of "protecting" one's image. Which is why one tends to get blasted with narcissistic rage calling the narcissist out -- seeing behind the curtain. They don't like that.

Hope that makes sense.