Coexisting primary early gastric plasmacytoma and sarcoidosis with hypercalcaemia.
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.
Morii
S
S
Department of Internal Medicine, Mito Saiseikai General Hospital, Ibaraki, Japan.
Oka
K
K
Naoi
Y
Y
Kotsuji
T
T
Nihei
T
T
Nagayama
R
R
Kashimura
K
K
Kameta
S
S
Yatabe
Y
Y
Mori
N
N
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
D009363:Neoplasm Proteins; C470121:PTHLH protein, human; D044162:Parathyroid Hormone-Related Protein; D011506:Proteins; D002762:Cholecalciferol