骨源性淋巴瘤伴继发性甲状旁腺机能亢进症1例报告并文献复习  

Bone lymphoma with secondary hyperparathyroidism: a case report and review

作　　者：徐才刚[1] 吴俣[1] 黄杰[1] 陈心传[1] 邓承祺[1] 

机构地区：[1]四川大学华西医院血液科临床流行病学教研室,成都610041

出　　处：《临床血液学杂志》2004年第2期98-100,共3页Journal of Clinical Hematology

摘　　要：目的 :探讨骨源性非霍奇金淋巴瘤 (NHL) (弥漫型大B细胞性 )伴继发性甲状旁腺机能亢进的诊断及机制。方法 :对 1例全身骨痛伴昏迷患者进行了骨髓图、骨髓病理及免疫组织化学、血液生化和CT检查 ,并复习文献就其诊治问题进行讨论。结果 :CT显示多部位骨质破坏 ,血钙及甲状旁腺激素水平显著升高 ,骨髓病理及免疫组织化学检查证实为骨源性NHL(弥漫型大B细胞性 ) ,最终诊断为骨源性NHL(弥漫型大B细胞性 )伴继发性甲状旁腺机能亢进。结论 :骨源性NHL的诊断有赖于病理组织学、免疫学和细胞遗传学检查以及CT及核素扫描。淋巴瘤细胞分泌甲状旁腺激素相关蛋白或相关多肽 (PTHrP) 。Objective: To investigate the diagnosis and mechanism of bone lymphoma (diffuse large B-cell lymphoma,DLBCL) with secondary hyperparathyroidism.Method:A case of a 31-year-old woman with diffuse bone pain and coma was reported. The bone marrow morphology, bone marrow pathology, immuno-histochemical stain, blood biochemical test and CT of total body were examind and the related articles were reviewed.Result: No enlarged lymph nodes were found.CT illustrated the pattern of osteolysis in her multi-skeletal.She had a high-level of blood calcium and parathyroid hormone, and finally she was diagnosed as the diffuse large B-cell lymphoma of bone non-Hodgkin lymphoma with secondary hyperparathyroidism by biochemical test, CT, bone marrow pathology and immuno-histochemical stain.Conclusion: The diagnosis of bone lymphoma was usually established by histopathology, immunology, cytogenetics, as well as CT and 67 Ga scintigraphy. The lymphoma cells secrete parathyroid hormone-related peptide (PTHrP). The hypercalcemia may be caused by the release of cytokines combined with PTHrp, as well as extensive osteolytic lesions.

关 键 词：非霍奇金淋巴瘤 甲状旁腺机能亢进 

分 类 号：R733.4[医药卫生—肿瘤]