Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0079731 (B-cell lymphoma)
 16,671 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Nearly one-half of all hypercalcemic patients with lymphoma present with inappropriately elevated circulating concentrations of the active vitamin D metabolite 1,25-dihydroxyvitamin D (1,25(OH)2D3). However, the cellular source of the vitamin D hormone in lymphomas remains unclear. To address this, we report the case of a 75-year-old man with hypercalcemia associated with raised circulating concentrations of 1,25(OH)2D3 and suppressed parathyroid hormone (PTH) levels. Positron emission tomographic (PET) and computed tomographic (CT) imaging revealed the presence of a large lymphoma that was confined to the spleen; subsequent pathological analysis showed that this was an intermediate grade B-cell lymphoma. After surgical removal of the spleen, serum calcium and 1,25(OH)2D3 levels became normalized within 24 h. Immunolocalization of the vitamin D-activating enzyme 25-hydroxyvitamin D3-1alpha-hydroxylase (la-hydroxylase) in sections of resected spleen showed that staining was negative in the lymphoma cells but positive in neighboring macrophages. This case study indicates that the hypercalcemia associated with lymphomas may be due, in some instances, to excessive extrarenal production of 1,25(OH)2D3. Furthermore, by using immunohistochemistry to assess the distribution of la-hydroxylase, we have been able to show for the first time that tissue macrophages, rather than actual tumor cells, are the most likely ectopic source of this enzyme. Based on this case study, we propose that the abnormal synthesis of 1,25(OH)2D3 associated with some lymphomas is because of paracrine regulation of tumor-associated macrophages.
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PMID:Vitamin D-mediated hypercalcemia in lymphoma: evidence for hormone production by tumor-adjacent macrophages. 1261 44

A 75-year-old white male presented with a one-month history of pain in the left shoulder. Early laboratory data revealed hypercalcemia. Extensive skeletal survey was remarkable for multiple lytic lesions in skull, right scapula, right humerus and left iliac crest. A bone marrow biopsy of the left iliac crest did not show evidence of plasma cell dyscrasia. A computed tomographic scan (CT) of the abdomen revealed a right renal mass and multiple lesions in the liver. A CT-guided biopsy of liver showed lymphoma cells strongly positive for CD19 and CD20 stains: findings consistent with B-cell lymphoma. Our case illustrates that B-cell lymphomas can clinically present in a fashion that mimics multiple myeloma in the form of hypercalcemia, renal failure and lytic bone lesions.
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PMID:B-cell lymphoma mimicking multiple myeloma. 1268 47

An 80-year-old woman was diagnosed with primary cutaneous B cell lymphoma. She had multifocal cutaneous tumors, but no nodal lymphadenopathy or bone marrow involvement. Histopathological examination of a biopsy specimen showed diffuse large B cell lymphoma without a bcl-2 expression. Complete resolution of hypercalcemia and disappearance of tumors were achieved with CHOP therapy, but a rapidly progressive skin lesion was observed soon after the completion of the therapy. The clinical manifestation of primary cutaneous diffuse large B cell lymphoma is diverse and the treatment strategy is not entirely clarified. This case represents another example of this rare lymphoma.
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PMID:Primary cutaneous diffuse large B cell lymphoma: a clinically aggressive case. 1272 26

We report a rare case of a patient with non-Hodgkin's lymphoma who developed multiple bone lesions and hypercalcemia. A 50-year-old woman complained of drowsiness and multiple bone pain on admission. Radiographic examination revealed multiple bone fractures and osteolytic lesions. She was diagnosed with diffuse large B cell lymphoma by biopsy of an inguinal lymph node. Elevation of parathyroid hormone-related protein (PTHrP) and hypercalcemia were confirmed pretreatment, and those serum levels decreased during chemotherapy for lymphoma. However, the disease was resistant to chemotherapy combined with rituximab. These findings suggest that hypercalcemia is associated with PTHrP and the prognosis of patients with bone lymphoma in advanced stage is poor, although it is thought to be a relatively favorable prognosis in localized primary lymphoma of bone.
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PMID:Non-Hodgkin's lymphoma presenting as multiple bone lesions and hypercalcemia. 1668 Jul 36

Humoral hypercalcemia of malignancy is a common metabolic disturbance associated with solid tumors, but it also occurs in lymphoma patients. Among these, low grade B-cell lymphoma accounts for only few cases, in which secretion of parathyroid hormone-related protein (PTHrP) remains even exceptional. We report the very rare case of a patient with a CLL type low grade leukemic B-cell lymphoma showing PTHrP-related hypercalcemia without evidence of bone lesions. Using immunohistochemistry, we demonstrate the cytoplasmic expression of PTHrP by the lymphoma cells in the bone marrow obtained at the onset of hypercalcemia. We postulate a pathogenetic role of leukemic cell production and secretion of PTHrP in hypercalcemia in low grade leukemic B-cell lymphoma.
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PMID:Parathyroid-hormone-related-protein-associated hypercalcemia in a patient with CLL-type low-grade leukemic B-cell lymphoma. 1719 51

We report a case of large cell B-cell lymphoma of the kidney associated with humoral hypercalcemia of malignancy. A 70-year-old man presented with renal failure and hypercalcemia. After the workup, the patient was thought to have renal cell carcinoma and underwent radical nephrectomy. The pathologic evaluation showed a large cell lymphoma with a B-cell phenotype. Reevaluation of the patient's serum revealed a high calcitriol level with low parathyroid hormone and parathyroid hormone-related protein levels, consistent with the final pathologic findings. The differential diagnosis of hypercalcemia in renal malignancy is presented.
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PMID:Differential diagnosis of hypercalcemia in renal malignancy. 1765 42

We analyzed a case with the blastoid variant of mantle cell lymphoma (MCL-BV), a rare subtype of B-cell lymphoma, presenting with marked hypercalcemia at diagnosis. Enzyme-linked immunosorbent assay (ELISA) showed elevated serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), macrophage inflammatory protein-1alpha (MIP-1alpha), and type I collagen telopeptide, but not parathyroid hormone, calcitriol or parathyroid hormone-related peptide at diagnosis, suggesting local osteoclastic hypercalcemia in this case. By reverse transcription polymerase chain reaction (RT-PCR) analysis, we found predominant expression of mRNA for MIP-1alpha in addition to those for receptor-activator of nuclear-factor kappa B ligand (RANKL), TNF-alpha, and IL-6 in lymphoma cells obtained from the patient. Furthermore, recombinant MIP-1alpha significantly stimulated (3)H-thymidine uptake by isolated MCL cells in vitro. Treatment with intravenous fluids, bisphosphonate, and methylprednisolone followed by combination chemotherapy promptly corrects the hypercalcemia and successfully induced complete remission, which was accompanied by a decrease of these cytokines in the serum, including MIP-1alpha. In the present case, MIP-1alpha, an osteoclast-activating factor produced by mantle lymphoma cells, may contribute to the development of hypercalcemia. It likely acts through RANKL expression in tumor cells and/or stroma cells, as indicated in multiple myeloma (MM) and adult T-cell leukemia/lymphoma (ATLL). Furthermore, MIP-1alpha is also involved in the development of an aggressive phenotype on MCL by stimulating proliferation of these lymphoma cells. In summary, the present study demonstrated that MIP-1alpha is an important factor in the development of both hypercalcemia and an aggressive phenotype in some types of B-cell lymphoma.
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PMID:Over-expression of CCL3 MIP-1alpha in a blastoid mantle cell lymphoma with hypercalcemia. 2005 Aug 82

We encountered a 58-year-old female patient who developed hypercalcemia and multiple bone lesions. She complained of lumbodorsal pain, nausea and vomiting on admission. Radiographic examination revealed multiple osteolytic lesions. She was diagnosed diffuse large B cell lymphoma (BLBCL) by bone marrow examination and biopsy of cervical lymph node. She underwent eight cycles of chemotherapy and is now in the stable stage. Osteogenic potential of mesenchymal stem cells from bone marrow was found to be correlated with the expression of Dickkopf1 (DKK-1) in the bone marrow plasma and lymphoma cells before and after treatment. PTH-related protein (PTHrP) expression was detectable in the lymphoma cells and was elevated in the serum. The receptor activator of nuclear factor kappaB ligand expression was found to be elevated in the bone marrow plasma and mesenchymal stem cells. These findings suggest that factors affecting the differentiation of both osteoblasts and osteoclasts involved in the pathogenesis of hypercalcemia and bone lesions of lymphoma. This was similar to that of multiple myeloma in which bone lesions and hypercalcemia are frequently observed.
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PMID:Multiple bone lesions and hypercalcemia presented in diffuse large B cell lymphoma: mimicking multiple myeloma? 2037 6

Two dogs, an 8.5-year-old intact male Golden Retriever and a 10-year-old spayed female English Springer Spaniel, each with varied clinical histories, were referred to the Colorado State University Veterinary Teaching Hospital for evaluation of hypercalcemia and severe anemia, respectively. In each dog, serum total protein and globulin concentrations were within reference intervals. Cytologic examination of bone marrow aspirates from both dogs revealed moderate to marked numbers of atypical lymphoid cells with plasma cell features. Using serum immunofixation and serum immunoglobulin (Ig) quantification, a monoclonal Ig protein was identified. In conjunction with other clinicopathologic and molecular findings, IgA secretory neoplasms, B-cell lymphoma with plasmacytoid features and multiple myeloma (MM), were diagnosed. To our knowledge, these cases represent the first descriptions of IgA-secreting neoplasms in dogs that lacked hyperglobulinemia. In cases of suspected B-cell lymphoma or MM in dogs, serum proteins should be fully evaluated for the presence of a monoclonal Ig even in dogs that lack characteristic hyperproteinemia or hyperglobulinemia. This evaluation will aid in the diagnosis of secretory B-cell lymphoma or MM leading to appropriate clinical and therapeutic case management.
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PMID:Monoclonal gammopathy without hyperglobulinemia in 2 dogs with IgA secretory neoplasms. 2096 7

Hypercalcemia is a rare metabolic disorder in course of B cell lymphoma. The mechanism of hypercalcemia in patients with malignancy may include the increased extrarenal production of vitamin D from tumoral cells or neighboring macrophages, i-PTH or PTHrP from tumoral cells. In this case we reported a 34 years old caucasian woman with acute renal failure and hypercalcemia as onset of splenic lymphoma in absence of abnormal levels of serum vitamin D and PTHrP. Because of dramatic recovery of renal function and hypercalcemia after splenectomy, we can speculate that main mechanism of hypercalcemia is related to vitamin D production from neighboring lymphoma macrophages.
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PMID:Acute renal failure and hypercalcemia as onset in splenic lymphoma. 2178 May 56


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