title: Diffuse large B-cell lymphoma presenting with hypercalcemia and multiple osteolysis.
abstract: 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.
authors.affiliation: First Department of Internal Medicine, Kagawa Medical University, Ikenobe, Miki-cho, Kagawa, 761-0793, Japan.
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Matsuhashi
authors.forename: Taizo
authors.initials: T
authors.lastname: Tasaka
authors.forename: Eisuke
authors.initials: E
authors.lastname: Uehara
authors.forename: Miharu
authors.initials: M
authors.lastname: Fujimoto
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Fujita
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tamura
authors.forename: Tohru
authors.initials: T
authors.lastname: Honda
authors.forename: Minoru
authors.initials: M
authors.lastname: Kuwajima
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Shimoura
authors.forename: Shohei
authors.initials: S
authors.lastname: Mano
authors.forename: Masami
authors.initials: M
authors.lastname: Nagai
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Ishida
mesh_terms: 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
chemical_list: 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