Unusual Manifestation of Intravascular Large B-Cell Lymphoma: Severe Hypercalcemia with Parathyroid Hormone-Related Protein
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Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of non-Hodgkinlymphoma. It usually presents with nonspecific symptoms, such as fever, rather thanwith overt lymphadenopathy. Reports of hypercalcemia, as the initial presentation ofIVLBCL, are limited in the literature, despite it being a well-known complication of varioussolid cancers. We present a 68-year-old male with severe hypercalcemia andincreased levels of serum parathyroid hormone-related protein. He was diagnosedwith IVLBCL, involving the bone marrow and spleen, and was successfully treated withrituximab-containing chemotherapy. A few previous case reports have shown hypercalcemiain patients with IVLBCL. Much like our case, previous cases with hypercalcemiahad advanced diseases, including bone marrow invasion. Although it was anextremely rare manifestation of IVLBCL, we suggest that IVLBCL should be a part ofthe differential diagnosis in patients with unexplained hypercalcemia. Therefore, anactive work-up might be recommended, including positron emission tomography/computed tomography scan and bone marrow examination, which may be useful forearly diagnosis.
Abstract
Intravascular large B-cell lymphoma (IVLBCL) is a rare subtype of non-Hodgkinlymphoma. It usually presents with nonspecific symptoms, such as fever, rather thanwith overt lymphadenopathy. Reports of hypercalcemia, as the initial presentation ofIVLBCL, are limited in the literature, despite it being a well-known complication of varioussolid cancers. We present a 68-year-old male with severe hypercalcemia andincreased levels of serum parathyroid hormone-related protein. He was diagnosedwith IVLBCL, involving the bone marrow and spleen, and was successfully treated withrituximab-containing chemotherapy. A few previous case reports have shown hypercalcemiain patients with IVLBCL. Much like our case, previous cases with hypercalcemiahad advanced diseases, including bone marrow invasion. Although it was anextremely rare manifestation of IVLBCL, we suggest that IVLBCL should be a part ofthe differential diagnosis in patients with unexplained hypercalcemia. Therefore, anactive work-up might be recommended, including positron emission tomography/computed tomography scan and bone marrow examination, which may be useful forearly diagnosis.
참고문헌 (14)
- Ponzoni M, "Definition, diagnosis, and management of intravascular large B-cell lymphoma: proposals and perspectives from an international consensus meeting", J Clin Oncol, 25, pp.3168~3173 (2007)
- Murase T, "An Asian variant of intravascular large B-cell lymphoma: clinical, pathological and cytogenetic approaches to diffuse large B-cell lymphoma associated with haemophagocytic syndrome", Br J Haematol, 111, pp.826~834 (2000)
- Ferreri AJ, "Intravascular lymphoma: clinical presentation, natural history, management and prognostic factors in a series of 38 cases, with special emphasis on the 'cutaneous variant'", Br J Haematol, 127, pp.173~183 (2004)
- Masaki Y, "Intravascular large B cell lymphoma: proposed of the strategy for early diagnosis and treatment of patients with rapid deteriorating condition", Int J Hematol, 89, pp.600~610 (2009)
- Stewart AF, "Clinical practice. Hypercalcemia associated with cancer", N Engl J Med, 352, pp.373~379 (2005)
- Yousem SA, "Intravascular lymphomatosis presenting in the lung", Cancer, 65, pp.349~353 (1990)
- Knobel B, "Malignant humoral hypercalcemia associated with angiotropic large B cell lymphoma", Harefuah, 140, pp.204~ (2001)
- Hanihara T, "Parathyroid hormone-related protein-associated hypercalcemia in probable intravascular lymphoma of B-cell type", Am J Hematol, 53, pp.144~145 (1996)
- Curtis JL, "Intravascular (angiotropic) large-cell lymphoma ('malignant angioendotheliomatosis') with small vessel pulmonary vascular obstruction and hypercalcemia", West J Med, 155, pp.72~76 (1991)
- Chinen Y, "Intravascular B-cell lymphoma with hypercalcemia as the initial presentation", Int J Hematol, 94, pp.567~570 (2011)
- Endres DB, "Investigation of hypercalcemia", Clin Biochem, 45, pp.954~963 (2012)
- Seymour JF, "Calcitriol production in hypercalcemic and normocalcemic patients with non-Hodgkin lymphoma", Ann Intern Med, 121, pp.633~640 (1994)
- Hewison M, "Vitamin D-mediated hypercalcemia in lymphoma: evidence for hormone production by tumor-adjacent macrophages", J Bone Miner Res, 18, pp.579~582 (2003)
- Shimada K, "Retrospective analysis of intravascular large B-cell lymphoma treated with rituximab-containing chemotherapy as reported by the IVL study group in Japan", J Clin Oncol, 26, pp.3189~3195 (2008)