[Extranodal non-Hodgkin's lymphoma associated with systemic bone metastasis and secondary myelofibrosis].
A 68-year-old woman was admitted in March 1997 because of lumbago, fever, vomiting, and general malaise. Laboratory data disclosed anemia and severe hypercalcemia (7.7 mEq/l). Multiple osteolytic lesions were detected in the patient's vertebra, pelvis, and bilateral tibia by x-ray films and 99mTc bone scintigrams. Bone marrow aspiration sample was not obtained due to dry tap. Marked myelofibrosis and proliferation of lymphoid cells were revealed by a bone marrow biopsy specimen. Immunohistochemical analysis showed that cells in the biopsy specimen were positive for L-26 and LCA, but not for UCHL-1. Gastrointestinal endoscopic examination found multiple polypoid lesions in the stomach; biopsy specimens of the lesion tissue disclosed invasion by B lymphoid cells. A diagnosis of diffuse large B cell lymphoma was thus made. THP-COP chemotherapy was performed, but only minimal response was obtained. Lymphoma cells subsequently invaded the brain stem, and the patient eventually died of respiratory failure.
Kasahara
K
K
First Department of Internal Medicine, Sapporo Medical University School of Medicine.
Takahashi
T
T
Oka
T
T
Yamamoto
M
M
Sirata
T
T
Idogawa
M
M
Naeshiro
M
M
Hayashi
T
T
Adachi
M
M
Hinoda
Y
Y
Imai
K
K
D000368:Aged; D001859:Bone Neoplasms / Q000473:pathology*; D001932:Brain Neoplasms / Q000473:pathology; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000473:pathology*; D009361:Neoplasm Invasiveness; D055728:Primary Myelofibrosis / Q000209:etiology*; D013274:Stomach Neoplasms / Q000473:pathology