[Humoral hypercalcemia revealing a malignant non hodgkin lymphoma].
BACKGROUND
Hypercalcemia is a rare complication of non-Hodgkin lymphoma. Usually, hypercalcemia occurs late in the disease course, except for high-grade lymphoma. Most often hypercalcemia is related to excessive level of circulating PTH-rP or sometimes, 1,25(OH)2D3. Concomitant high plasmatic concentration of PTH-rP and 1,25(OH)2D3 is uncommon.


METHODS
We report the case of a 82-year-old man who presented with abdominal pain and weight loss, leading to the diagnosis of diffuse large-B-cell lymphoma (high-grade lymphoma) associated with symptomatic hypercalcemia (3.21mmol/l). PTH-rP and 1,25(OH)2D3 plasmatic levels were high. Calcium concentration was normalized with glucocorticoids and sequential chemotherapy.


CONCLUSIONS
This case report confirms that hypercalcemia, as consequence of excessive plasmatic level of PTH-rP secreted by tumoral cells, can occur early in the course of high-grade lymphoma. Glucocorticoids and chemotherapy are the best treatment options.
Amezyane
T
T
Clinique médicale, hôpital d'Instruction des Armées du Val-de-Grace, 00446 Armées Paris cedex, France. amez.tao@caramail.com
Lecoules
S
S
Bordier
L
L
Blade
J-S
JS
Desramé
J
J
Bechade
D
D
Coutant
G
G
Algayres
J-P
JP
D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D006801:Humans; D006934:Hypercalcemia / Q000209:etiology*; D008228:Lymphoma, Non-Hodgkin / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000188:drug therapy; D008297:Male; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000970:Antineoplastic Agents