title: Coexisting primary early gastric plasmacytoma and sarcoidosis with hypercalcaemia.
abstract: We report on a 61-year-old woman with coexisting early stage primary gastric plasmacytoma and sarcoidosis with hypercalcaemia. Laboratory data on admission showed hypercalcaemia, with 12.8 mg/dl, parathyroid hormone-related peptide (PTHrP) 1.2 pmol/l, C-PTHrP 69.5 pmol/l, and 1,25-dihydroxyvitamin D3 46.7 pg/ml. Neoplastic plasma cells proliferated in the propria mucosa of the stomach, showed a monoclonal immunoglobulin of cytoplasmic IgA (lambda light chain) and were positive for leucocyte common antigen and epithelial membrane antigen on paraffin section prepared from a stomach biopsy specimen. Russel bodies were present, as were crystals. Abundant sarcoid granulomas were observed in many of the regional lymph nodes around the stomach and in the dermis of a skin nodule. The patient underwent subtotal gastrectomy with administration of antimyeloma chemotherapy. We suggest that the hypercalcaemia in this patient was due to PTHrP production by neoplastic plasma cells.
authors.affiliation: Department of Internal Medicine, Mito Saiseikai General Hospital, Ibaraki, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Morii
authors.forename: K
authors.initials: K
authors.lastname: Oka
authors.forename: Y
authors.initials: Y
authors.lastname: Naoi
authors.forename: T
authors.initials: T
authors.lastname: Kotsuji
authors.forename: T
authors.initials: T
authors.lastname: Nihei
authors.forename: R
authors.initials: R
authors.lastname: Nagayama
authors.forename: K
authors.initials: K
authors.lastname: Kashimura
authors.forename: S
authors.initials: S
authors.lastname: Kameta
authors.forename: Y
authors.initials: Y
authors.lastname: Yatabe
authors.forename: N
authors.initials: N
authors.lastname: Mori
mesh_terms: D002762:Cholecalciferol / Q000097:blood; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000097:blood / Q000150:complications* / Q000473:pathology; D007150:Immunohistochemistry; D008875:Middle Aged; D009363:Neoplasm Proteins / Q000378:metabolism; D044162:Parathyroid Hormone-Related Protein; D010954:Plasmacytoma / Q000097:blood / Q000150:complications* / Q000473:pathology; D011506:Proteins / Q000378:metabolism; D012507:Sarcoidosis / Q000097:blood / Q000150:complications* / Q000473:pathology; D013274:Stomach Neoplasms / Q000097:blood / Q000150:complications* / Q000473:pathology
chemical_list: D009363:Neoplasm Proteins; C470121:PTHLH protein, human; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins; D002762:Cholecalciferol