Jacobson J O, Bringhurst F R, Harris N L, Weitzman S A, Aisenberg A C
Hematology/Oncology Unit, Massachusetts General Hospital, Boston 02114.
Cancer. 1989 Mar 1;63(5):917-23. doi: 10.1002/1097-0142(19890301)63:5<917::aid-cncr2820630522>3.0.co;2-e.
To provide further understanding of humoral hypercalcemia in Hodgkin's disease (HD) the authors describe the clinical features and laboratory investigation of three patients recently treated at Massachusetts General Hospital. All were middle-aged men who presented with symptomatic hypercalcemia which led to a diagnosis of bulky intraabdominal HD. None had evidence of bone involvement or hyperparathyroidism. In the two cases tested 1,25(OH)2D3 was elevated at the time of diagnosis. These characteristics are remarkably similar to those of ten patients with HD and probable humoral hypercalcemia described in the literature. The diagnosis of HD was supported in Cases 1 and 3 by genomic blot analysis which showed no evidence of T-cell or B-cell tumor origin. In an in vitro assay, primary tumor medium from Case 1 stimulated dose-dependent bone resorption which was not entirely ascribable to 1,25(OH)2D3. The authors conclude that humoral hypercalcemia in HD predominantly affects males of middle age, that intraabdominal bulky disease is common, and that hypercalcemia appears to be mediated by tumor related production of 1,25(OH)2D3 in concert with a second factor.
为了进一步了解霍奇金淋巴瘤（HD）中的体液性高钙血症，作者描述了最近在麻省总医院接受治疗的三名患者的临床特征和实验室检查情况。所有患者均为中年男性，表现为有症状的高钙血症，最终诊断为腹部巨大HD。均无骨受累或甲状旁腺功能亢进的证据。在检测的两例病例中，诊断时1,25(OH)2D3升高。这些特征与文献中描述的10例HD及可能的体液性高钙血症患者的特征非常相似。病例1和病例3通过基因组印迹分析支持HD的诊断，该分析显示没有T细胞或B细胞肿瘤起源的证据。在一项体外试验中，病例1的原发性肿瘤培养基刺激了剂量依赖性骨吸收，这并不完全归因于1,25(OH)2D3。作者得出结论，HD中的体液性高钙血症主要影响中年男性，腹部巨大病变常见，高钙血症似乎是由肿瘤相关的1,25(OH)2D3产生与第二种因素共同介导的。
