Diffuse large B-cell lymphoma presenting with hypercalcemia and multiple osteolysis.
Osteolysis and hypercalcemia are observed in 5-15%, and 10%, respectively, of malignant lymphoma patients during their clinical course. However, both osteolysis and hypercalcemia are uncommon at onset of the disease. We encountered a 24-year-old male non-Hodgkin's lymphoma patient who had multiple osteolytic lesion from the onset of the disease and repeated episodes of hypercalcemia during the clinical course. The patient died with refractory disease. We studied the expression of chemokines which might affect bone resorption using the reverse transcriptase-polymerase chain reaction (RT-PCR) method. Increased expressions of MIP-1alpha, MIP-1beta and RANKL, which are osteoclast-activating factors, were observed in the RNA derived from the patient's lymphoma cells. The secretion of osteoclast-activating factors such as MIP-1alpha by the tumor cells (and/or bone marrow stromal cells) might be involved in the etiology of osteolysis and hypercalcemia in some malignant lymphoma cases.
Matsuhashi
Yoshiko
Y
First Department of Internal Medicine, Kagawa Medical University, Ikenobe, Miki-cho, Kagawa, 761-0793, Japan.
Tasaka
Taizo
T
Uehara
Eisuke
E
Fujimoto
Miharu
M
Fujita
Mitsuhiro
M
Tamura
Takahiro
T
Honda
Tohru
T
Kuwajima
Minoru
M
Shimoura
Yasumasa
Y
Mano
Shohei
S
Nagai
Masami
M
Ishida
Toshihiko
T
D000135:Acid Phosphatase / Q000378:metabolism; D000328:Adult; D001706:Biopsy; D001854:Bone Marrow Cells / Q000166:cytology; D001862:Bone Resorption; D002352:Carrier Proteins / Q000096:biosynthesis; D054405:Chemokine CCL3; D054407:Chemokine CCL4; D018925:Chemokines / Q000096:biosynthesis; D017809:Fatal Outcome; D006801:Humans; D006934:Hypercalcemia / Q000175:diagnosis*; D016130:Immunophenotyping; D007527:Isoenzymes / Q000378:metabolism; D017116:Low Back Pain; D016393:Lymphoma, B-Cell / Q000175:diagnosis* / Q000473:pathology; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000473:pathology; D019402:Macrophage Inflammatory Proteins / Q000096:biosynthesis*; D008279:Magnetic Resonance Imaging; D008297:Male; D008562:Membrane Glycoproteins / Q000096:biosynthesis; D010010:Osteoclasts / Q000378:metabolism; D010014:Osteolysis / Q000175:diagnosis*; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; D020133:Reverse Transcriptase Polymerase Chain Reaction; D000071681:Tartrate-Resistant Acid Phosphatase
D002352:Carrier Proteins; D054405:Chemokine CCL3; D054407:Chemokine CCL4; D018925:Chemokines; D007527:Isoenzymes; D019402:Macrophage Inflammatory Proteins; D008562:Membrane Glycoproteins; D053245:RANK Ligand; D053246:Receptor Activator of Nuclear Factor-kappa B; C505686:TNFRSF11A protein, human; C505688:TNFSF11 protein, human; D000135:Acid Phosphatase; D000071681:Tartrate-Resistant Acid Phosphatase