Severe hypercalcemia due to large B-cell non-Hodgkin lymphoma

Nave, João Trindade; Pinheiro, Luís Santos; Lucas, Margarida; Victorino, Rui M. M.

doi:10.1016/j.ejim.2013.08.444

Cited by 2 publications

(6 citation statements)

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“…Some studies suggest that hypercalcemia of malignancy occurs in up to 44.1% of patients diagnosed with cancer and is more prevalent in patients with advanced stages [10,12]. About 15% of patients with NHL will be affected by hypercalcemia during their disease course [13]. Symptoms secondary to hypercalcemia include lethargy, abdominal pain, nausea, vomiting, constipation, anorexia, cognitive dysfunction, and polyuria [9,13].…”

Section: Discussionmentioning

confidence: 99%

“…About 15% of patients with NHL will be affected by hypercalcemia during their disease course [13]. Symptoms secondary to hypercalcemia include lethargy, abdominal pain, nausea, vomiting, constipation, anorexia, cognitive dysfunction, and polyuria [9,13].…”

Section: Discussionmentioning

confidence: 99%

“…2023;14 (6):570-574 teoblasts to enhance the production of nuclear factor-κB (RANK) and its respective ligand (RANK-L). The downstream effect of this interaction is a subsequent increase in osteoclast activity and bone resorption, thus translating to an increased level of calcium in the blood [10,13]. The second most common mechanism, accounting for about 20% of cases, is via metastasis of malignant cells into the bone marrow.…”

Section: Discussionmentioning

confidence: 99%

“…The third mechanism of hypercalcemia of malignancy includes tumor production of calcitriol (1,25-dihydroxycholecalciferol). This causes an increased intestinal absorption of calcium and phosphate along with decreased renal calcium excretion [9,10,13].…”

Section: Discussionmentioning

confidence: 99%

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Catch the Calcium: T-Cell Histiocyte-Rich B-Cell Lymphoma Presenting as Hypercalcemia

Okeke,

Harmon,

Okeke

et al. 2023

World J Oncol

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T-cell/histiocyte-rich large B-cell lymphoma (THRLBCL) is an extremely rare and aggressive subtype of diffuse large B-cell lymphoma (DLBCL) that typically presents in middle-aged patients and carries a poor prognosis. Hypercalcemia presenting as the initial manifestation of the disease is rare, with only one other case reported in the literature. We report a case of a 90-year-old male who presented with progressive lethargy and unintentional weight loss. Initial workup showed elevated serum calcium of 14.6 mg/dL, corrected for albumin, and creatinine of 1.51 mg/dL. He had a suppressed iPTH of 6.3 pg/mL and normal PTHrP (13 pg/mL). Computed tomography (CT) scan of the abdomen and pelvis was performed to rule out underlying malignancy, which showed splenomegaly and enlarged retrocrural and porta hepatis lymph nodes. Bone marrow biopsy was performed to evaluate for hematological malignancy, which revealed findings diagnostic of THRLBCL. While rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) is one of the mainstay therapies for DLBCL and has been shown to have comparable outcomes in THRLBCL, there are documented concerns with its toxicity profile limiting the ability of older patients (60 years and older) to complete therapy. Our patient was treated with R-mini-CHOP, which is much better tolerated in this patient demographic. R-mini-CHOP features decreased doses of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP) with the conventional dose of rituximab. This case discusses a rare subtype of non-Hodgkin lymphoma presenting with a unique manifestation of hypercalcemia. We highlight the importance of thorough investigation for causes of hypercalcemia as well as the efficacy and tolerability of R-mini-CHOP in this elderly patient demographic.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Catch the Calcium: T-Cell Histiocyte-Rich B-Cell Lymphoma Presenting as Hypercalcemia

Okeke,

Harmon,

Okeke

et al. 2023

World J Oncol

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“…Hypercalcaemia occurs in 15% of patients with lymphoma during the course of the disease and rarely occurs at presentation. B cell lymphoma with hypercalcaemia is less frequent (7–8%) than other types of lymphoma [ 55 ]. According to a retrospective study of 1,200 patients with B-CLL, only 7 patients (0.006%) had hypercalcaemia [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

Preventive Healthcare and Management for Acute Lymphoblastic Leukaemia in Adults: Case Report and Literature Review

et al. 2021

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Acute lymphoblastic leukaemia (ALL) is diagnosed by the presence of at least 20% lymphoblasts in the bone marrow. ALL may be aggressive and include the lymph nodes, liver, spleen, central nervous system (CNS), and other organs. Without early recognition and timely treatment, ALL will progress quickly and may have poor prognosis in clinical scenarios. ALL is a rare type of leukaemia in adults but is the most common type in children. Precipitating factors such as environmental radiation or chemical exposure, viral infection, and genetic factors can be associated with ALL. We report a rare case of ALL with symptomatic hypercalcaemia in an adult woman. The patient presented with general weakness, poor appetite, bilateral lower limbs oedema, consciousness disturbance, and lower back pain for 3 weeks. She had a history of cervical cancer and had undergone total hysterectomy, chemotherapy, and radiation therapy. Her serum calcium level was markedly increased, at 14.1 mg/dl at admission. Neck magnetic resonance imaging, abdominal sonography, abdominal computed tomography, and bone marrow examination were performed. Laboratory data, including intact parathyroid hormone (i-PTH), peripheral blood smear, and 25-(OH) D3, were checked. Bone marrow biopsy showed B cell lymphoblastic leukaemia. Chemotherapy was initiated to be administered but was discontinued due to severe sepsis. Finally, the patient died due to septic shock. This was a rare case of B cell ALL in an adult complicated by hypercalcaemic crisis, which could be a life-threatening emergency in clinical practice. Physicians should pay attention to the associated risk factors. Early recognition and appropriate treatment may improve clinical outcomes.

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Severe hypercalcemia due to large B-cell non-Hodgkin lymphoma

Cited by 2 publications

References 0 publications

Catch the Calcium: T-Cell Histiocyte-Rich B-Cell Lymphoma Presenting as Hypercalcemia

Catch the Calcium: T-Cell Histiocyte-Rich B-Cell Lymphoma Presenting as Hypercalcemia

Preventive Healthcare and Management for Acute Lymphoblastic Leukaemia in Adults: Case Report and Literature Review

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