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Adult T-type lymphoblastic lymphoma presenting as hypercalcemic crisis and aplastic anemia: a case report

BACKGROUND: Hypercalcemia and aplastic anemia are two uncommon presentations of non-Hodgkin lymphoma that potentially worsen the disease prognosis. Although hypercalcemia has been reported in the B-cell subtypes and some T-cell subtypes of non-Hodgkin lymphoma, it has not been described in T-cell ly...

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Autores principales: Essouma, Mickael, Soh, Dorothée M., Temgoua, Mazou N., Gobina, Ronald M., Nono, Aristide T., Atenguena, Etienne Olivier, Maimouna, Mahamat, Ashuntantang, Gloria E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781379/
https://www.ncbi.nlm.nih.gov/pubmed/31594542
http://dx.doi.org/10.1186/s13256-019-2225-2
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author Essouma, Mickael
Soh, Dorothée M.
Temgoua, Mazou N.
Gobina, Ronald M.
Nono, Aristide T.
Atenguena, Etienne Olivier
Maimouna, Mahamat
Ashuntantang, Gloria E.
author_facet Essouma, Mickael
Soh, Dorothée M.
Temgoua, Mazou N.
Gobina, Ronald M.
Nono, Aristide T.
Atenguena, Etienne Olivier
Maimouna, Mahamat
Ashuntantang, Gloria E.
author_sort Essouma, Mickael
collection PubMed
description BACKGROUND: Hypercalcemia and aplastic anemia are two uncommon presentations of non-Hodgkin lymphoma that potentially worsen the disease prognosis. Although hypercalcemia has been reported in the B-cell subtypes and some T-cell subtypes of non-Hodgkin lymphoma, it has not been described in T-cell lymphoblastic lymphoma. The same applies to aplastic anemia, which is also not described in T-type lymphomas. CASE PRESENTATION: We report a case of a 52-year-old Cameroonian man with acute kidney injury who presented with confusion, abdominal pain, constipation, polyuria, polydipsia, calciphylaxis, enlarged lymph nodes, tachycardia, and a blood pressure of 170/88 mmHg. Laboratory investigations revealed hypercalcemia (total/ionized 199.5/101.75 mg/L), normal serum phosphorus (40.20 mg/L), and a low intact parathyroid hormone (9.70 pg/ml). Complete blood count revealed pancytopenia. Peripheral blood smear confirmed thrombocytopenia but showed neither blasts nor flower cells. Bone marrow aspirate revealed hypocellularity with no blasts or fibrosis. Lymph node biopsy was suggestive of T-cell precursor lymphoma. T-lymphoblastic lymphoma presenting with hypercalcemic crisis and aplastic anemia was diagnosed, and the patient received the cyclophosphamide-doxorubicin-vincristine-prednisone protocol of chemotherapy together with filgrastim and whole-blood transfusion for aplastic anemia. The short-term outcome was fatal, however. CONCLUSIONS: Severe hypercalcemia and aplastic anemia are potential paraneoplastic syndromes of adult T-type lymphoblastic lymphoma, with fatal short-term outcome.
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spelling pubmed-67813792019-10-17 Adult T-type lymphoblastic lymphoma presenting as hypercalcemic crisis and aplastic anemia: a case report Essouma, Mickael Soh, Dorothée M. Temgoua, Mazou N. Gobina, Ronald M. Nono, Aristide T. Atenguena, Etienne Olivier Maimouna, Mahamat Ashuntantang, Gloria E. J Med Case Rep Case Report BACKGROUND: Hypercalcemia and aplastic anemia are two uncommon presentations of non-Hodgkin lymphoma that potentially worsen the disease prognosis. Although hypercalcemia has been reported in the B-cell subtypes and some T-cell subtypes of non-Hodgkin lymphoma, it has not been described in T-cell lymphoblastic lymphoma. The same applies to aplastic anemia, which is also not described in T-type lymphomas. CASE PRESENTATION: We report a case of a 52-year-old Cameroonian man with acute kidney injury who presented with confusion, abdominal pain, constipation, polyuria, polydipsia, calciphylaxis, enlarged lymph nodes, tachycardia, and a blood pressure of 170/88 mmHg. Laboratory investigations revealed hypercalcemia (total/ionized 199.5/101.75 mg/L), normal serum phosphorus (40.20 mg/L), and a low intact parathyroid hormone (9.70 pg/ml). Complete blood count revealed pancytopenia. Peripheral blood smear confirmed thrombocytopenia but showed neither blasts nor flower cells. Bone marrow aspirate revealed hypocellularity with no blasts or fibrosis. Lymph node biopsy was suggestive of T-cell precursor lymphoma. T-lymphoblastic lymphoma presenting with hypercalcemic crisis and aplastic anemia was diagnosed, and the patient received the cyclophosphamide-doxorubicin-vincristine-prednisone protocol of chemotherapy together with filgrastim and whole-blood transfusion for aplastic anemia. The short-term outcome was fatal, however. CONCLUSIONS: Severe hypercalcemia and aplastic anemia are potential paraneoplastic syndromes of adult T-type lymphoblastic lymphoma, with fatal short-term outcome. BioMed Central 2019-10-08 /pmc/articles/PMC6781379/ /pubmed/31594542 http://dx.doi.org/10.1186/s13256-019-2225-2 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Essouma, Mickael
Soh, Dorothée M.
Temgoua, Mazou N.
Gobina, Ronald M.
Nono, Aristide T.
Atenguena, Etienne Olivier
Maimouna, Mahamat
Ashuntantang, Gloria E.
Adult T-type lymphoblastic lymphoma presenting as hypercalcemic crisis and aplastic anemia: a case report
title Adult T-type lymphoblastic lymphoma presenting as hypercalcemic crisis and aplastic anemia: a case report
title_full Adult T-type lymphoblastic lymphoma presenting as hypercalcemic crisis and aplastic anemia: a case report
title_fullStr Adult T-type lymphoblastic lymphoma presenting as hypercalcemic crisis and aplastic anemia: a case report
title_full_unstemmed Adult T-type lymphoblastic lymphoma presenting as hypercalcemic crisis and aplastic anemia: a case report
title_short Adult T-type lymphoblastic lymphoma presenting as hypercalcemic crisis and aplastic anemia: a case report
title_sort adult t-type lymphoblastic lymphoma presenting as hypercalcemic crisis and aplastic anemia: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6781379/
https://www.ncbi.nlm.nih.gov/pubmed/31594542
http://dx.doi.org/10.1186/s13256-019-2225-2
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