tailieunhanh - báo cáo khoa học: " Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin’s lymphoma: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin’s lymphoma: a case report | Ghazi et al. Journal of Medical Case Reports 2010 4 330 http content 4 1 330 jAl JOURNALOF medical ÌỤr case REPORTS CASE REPORT Open Access Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin s lymphoma a case report All A i l l 71 1 I_I .-V. I u A e iri i 2 A H r I 2A Px fx I I . x r v 7 A Px II- I 13 r l-x I I .-V. I Ì I I . V. 1- 5 All AM Ghazi Hamid Attarian Shirin Attarian Abolghasem Abasahl EDrahim Daryani EDrahim rarasat K lorino Prsi iroflcori6 I- crivxl H Timori7 l l rcho 7i1 Idfv .IW8 Marina rouiaikaii raiiokh liigaii Siavash M Ghazi Kalman Kovacs Abstract 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 2D3 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 .