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Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin's lymphoma: a case report

INTRODUCTION: Hypercalcemia is the major electrolyte abnormality in patients with malignant tumors. It can be due to localized osteolytic hypercalcemia or elaboration of humoral substances such as parathyroid hormone-related protein from tumoral cells. In hematological malignancies, a third mechanis...

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Autores principales: Ghazi, Ali AM, Attarian, Hamid, Attarian, Shirin, Abasahl, Abolghasem, Daryani, Ebrahim, Farasat, Ebrahim, Pourafkari, Marina, Tirgari, Farrokh, Ghazi, Siavash M, Kovacs, Kalman
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974746/
https://www.ncbi.nlm.nih.gov/pubmed/20959010
http://dx.doi.org/10.1186/1752-1947-4-330
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author Ghazi, Ali AM
Attarian, Hamid
Attarian, Shirin
Abasahl, Abolghasem
Daryani, Ebrahim
Farasat, Ebrahim
Pourafkari, Marina
Tirgari, Farrokh
Ghazi, Siavash M
Kovacs, Kalman
author_facet Ghazi, Ali AM
Attarian, Hamid
Attarian, Shirin
Abasahl, Abolghasem
Daryani, Ebrahim
Farasat, Ebrahim
Pourafkari, Marina
Tirgari, Farrokh
Ghazi, Siavash M
Kovacs, Kalman
author_sort Ghazi, Ali AM
collection PubMed
description INTRODUCTION: Hypercalcemia is the major electrolyte abnormality in patients with malignant tumors. It can be due to localized osteolytic hypercalcemia or elaboration of humoral substances such as parathyroid hormone-related protein from tumoral cells. In hematological malignancies, a third mechanism of uncontrolled synthesis and secretion of 1-25(OH)(2)D(3 )from tumoral cells or neighboring macrophages may contribute to the problem. However, hypercalcemia is quite unusual in patients with B-cell non-Hodgkin's lymphoma. CASE PRESENTATION: An 85-year-old Caucasian woman presented with low grade fever, anorexia, abdominal discomfort and fullness in her left abdomen for the last six months. She was mildly anemic and complained of fatigability. She had huge splenomegaly and was hypercalcemic. After correction of her hypercalcemia, she had a splenectomy. Microscopic evaluation revealed a malignant lymphoma. Her immunohistochemistry was positive for leukocyte common antigen, CD20 and parathyroid hormone-related peptide. CONCLUSION: Immunopositivity for parathyroid hormone-related peptide clearly demonstrates that hypersecretion of a parathyroid hormone-like substance from the tumor had led to hypercalcemia in this case. High serum calcium is seen in only seven to eight percent of patients with B-cell non-Hodgkin's lymphoma, apparently due to different mechanisms. Evaluation of serum parathyroid hormone-related protein and 1-25(OH)(2)D(3 )can be helpful in diagnosis and management. It should be noted that presentation with hypercalcemia has a serious impact on prognosis and survival.
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spelling pubmed-29747462010-11-06 Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin's lymphoma: a case report Ghazi, Ali AM Attarian, Hamid Attarian, Shirin Abasahl, Abolghasem Daryani, Ebrahim Farasat, Ebrahim Pourafkari, Marina Tirgari, Farrokh Ghazi, Siavash M Kovacs, Kalman J Med Case Reports Case Report INTRODUCTION: Hypercalcemia is the major electrolyte abnormality in patients with malignant tumors. It can be due to localized osteolytic hypercalcemia or elaboration of humoral substances such as parathyroid hormone-related protein from tumoral cells. In hematological malignancies, a third mechanism of uncontrolled synthesis and secretion of 1-25(OH)(2)D(3 )from tumoral cells or neighboring macrophages may contribute to the problem. However, hypercalcemia is quite unusual in patients with B-cell non-Hodgkin's lymphoma. CASE PRESENTATION: An 85-year-old Caucasian woman presented with low grade fever, anorexia, abdominal discomfort and fullness in her left abdomen for the last six months. She was mildly anemic and complained of fatigability. She had huge splenomegaly and was hypercalcemic. After correction of her hypercalcemia, she had a splenectomy. Microscopic evaluation revealed a malignant lymphoma. Her immunohistochemistry was positive for leukocyte common antigen, CD20 and parathyroid hormone-related peptide. CONCLUSION: Immunopositivity for parathyroid hormone-related peptide clearly demonstrates that hypersecretion of a parathyroid hormone-like substance from the tumor had led to hypercalcemia in this case. High serum calcium is seen in only seven to eight percent of patients with B-cell non-Hodgkin's lymphoma, apparently due to different mechanisms. Evaluation of serum parathyroid hormone-related protein and 1-25(OH)(2)D(3 )can be helpful in diagnosis and management. It should be noted that presentation with hypercalcemia has a serious impact on prognosis and survival. BioMed Central 2010-10-19 /pmc/articles/PMC2974746/ /pubmed/20959010 http://dx.doi.org/10.1186/1752-1947-4-330 Text en Copyright ©2010 Ghazi et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Ghazi, Ali AM
Attarian, Hamid
Attarian, Shirin
Abasahl, Abolghasem
Daryani, Ebrahim
Farasat, Ebrahim
Pourafkari, Marina
Tirgari, Farrokh
Ghazi, Siavash M
Kovacs, Kalman
Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin's lymphoma: a case report
title Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin's lymphoma: a case report
title_full Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin's lymphoma: a case report
title_fullStr Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin's lymphoma: a case report
title_full_unstemmed Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin's lymphoma: a case report
title_short Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin's lymphoma: a case report
title_sort hypercalcemia and huge splenomegaly presenting in an elderly patient with b-cell non-hodgkin's lymphoma: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2974746/
https://www.ncbi.nlm.nih.gov/pubmed/20959010
http://dx.doi.org/10.1186/1752-1947-4-330
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