title: [An elderly case of non-Hodgkin's lymphoma (NHL) with hypercalcemia].
abstract: 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.
authors.affiliation: Department of Endocrinology, Tokyo Metropolitan Geriatric Medical Center.
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Ota
authors.forename: Kohtarou
authors.initials: K
authors.lastname: Azuma
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Horiuchi
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kazama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Araki
authors.forename: Takayuki
authors.initials: T
authors.lastname: Hosoi
authors.forename: Motoji
authors.initials: M
authors.lastname: Sawabe
authors.forename: Norio
authors.initials: N
authors.lastname: Amizuka
authors.forename: Hajime
authors.initials: H
authors.lastname: Orimo
mesh_terms: 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
chemical_list: C470121:PTHLH protein, human; D044162:Parathyroid Hormone-Related Protein; D036361:Peptide Hormones