Adult T-cell Leukemia with Hypercalcemia-induced Metastatic Calcification in the Lungs Due to Production of Parathyroid Hormone-related Protein.

Abstract

A 60-year-old manwas diagnosed as adult T-cell leukemia with severe hypercalcemia because of production of parathyroid hormone-related protein. After admission, the patient had respiratory insufficiency with an infiltrative shadow in his lungs suggestive of pneumonia. However, neither improvement in respiratory function nor disappearance of the abnormal chest shadowwas observed with administration of various antibiotics. Anautopsy demonstrated the chest shadow had been caused by metastatic calcification associated with hypercalcemia due to production of parathyroid hormone-related protein. The possibility of metastatic calcification should be considered in patients with adult T-cell leukemia and hypercalcemia who have an abnormal chest shadow. (Internal Medicine 40: 409-413, 2001)

Pathogenesis of Metastatic Calcification and Acute Pancreatitis in Adult T-Cell Leukemia under Hypercalcemic State

“…We reported previously that serum calcium levels ranged from 15.4 to 19.4 mg/dL (normal range: 8.4 to 10.4 mg/dL) in ATL patients with metastatic calcification [22]. The possibility of metastatic calcification should be considered in ATL patients associated with hypercalcemia who have abnormal shadow by roentgenogram [35, 39]. Other useful diagnostic procedures are imaging with computed tomography (CT) [35], magnetic resonance (MR) [40], and bone scintigraphy [35].…”

Noninfectious Causes of Diffuse Pulmonary Infiltrations in Chronic Renal Failure: Metastatic Pulmonary Calsification

“…Metastatic pulmonary calcifications have been described as airspace opacities simulating pulmonary edema or pneumonia on chest radiographs. Metastatic pulmonary calcifications can also appear as an interstitial pattern or diffuse calcific nodules on chest X-ray [2,6]. High-resolution computed tomography (HRCT) has high sensitivity for the detection and characterization of parenchymal calcification.…”

“…Calcium phosphate crystals come into existence on necrotic or inflamed cells. Uncommonly, MPC is seen in patients with normal renal functions, normal calcium and phosphate levels and without underlying lung disease [1][2][3][4][5][6][7][8][9][10]. Chest radiographs of MPC reveal multiple diffuse calcified nodulesand confluent or patchy airspace opacities simulating diffuse interstitial process, pulmonary edema, pneumonia, alveolar hemorrhage, hypersensitivity pneumonitis, vasculitis, sarcoidosis, chronic eosinophilic pneumonia, occupational lung disease and pulmonary alveolar microlithiasis [11,12].…”

Benign Tumors and Tumor-like Lesions of the Lung

“…[38][39][40][41][42][43][44][45][46] Metastatic calcification may occur in any age group and in both male and female patients. Conventional chest radiographs may not be as accurate as CT scans (Fig.…”

“…38 Placental transmogrification. The papillary-like structure is composed almost exclusively of mature adipose tissue with a rim of epithelial cells.…”