[An elderly case of non-Hodgkin's lymphoma (NHL) with hypercalcemia].
A 93 year-old woman was admitted due to anorexia and unconsciousness. Biochemical examination of serum showed hypercalcemia (corrected Ca; 16.6 mg/dl). The level of intact parathyroid hormone (i-PTH) was suppressed, whereas parathyroid hormone-related peptide (PTHrp) was to 5.0 pM (normal range: below 0.6 pM). IL-6 and renal cAMP were also elevated. We started to ameliorate hypercalcemia by saline infusion, furosemide and calcitonin. However, hypercalcemia was not improved and the patient died of DIC and renal failure. Autopsy revealed primary lesion of NHL (diffuse large B cell type) to be in the stomach with infiltration of lymphoma into the liver, pancreas, spleen, adrenal glands, jejunum, and lumbar vertebrae. The results of immunohistochemical examination demonstrated the expression of PTHrP in lymphoma cells. PTHrP was also found in lymphoma cells of the spleen by the RT-PCR technique. These findings indicated that hypercalcemia was caused by overexpression of PTHrP from lymphoma cells.
Ota
Hidetaka
H
Department of Endocrinology, Tokyo Metropolitan Geriatric Medical Center.
Azuma
Kohtarou
K
Horiuchi
Toshiyuki
T
Kazama
Hirohito
H
Araki
Atsushi
A
Hosoi
Takayuki
T
Sawabe
Motoji
M
Amizuka
Norio
N
Orimo
Hajime
H
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D008228:Lymphoma, Non-Hodgkin / Q000150:complications*; D009384:Paraneoplastic Endocrine Syndromes / Q000150:complications*; D044162:Parathyroid Hormone-Related Protein; D036361:Peptide Hormones / Q000378:metabolism; D013274:Stomach Neoplasms / Q000473:pathology
C470121:PTHLH protein, human; D044162:Parathyroid Hormone-Related Protein; D036361:Peptide Hormones