Ding Luyin, Xiao Xibin, Huang Liansheng
Department of Hematology, The Second Affiliated Hospital of Zhejiang University Medical College, Hangzhou, Zhejiang 310009, P.R. China.
Oncol Lett. 2015 Jan;9(1):231-234. doi: 10.3892/ol.2014.2661. Epub 2014 Nov 3.
The present study reports the case of a 61-year-old male with polymyositis who presented with exacerbated weakness in the lower limbs and a recurrent fever that had persisted for one month. Positron emission tomography/computed tomography scans revealed multiple regions of elevated fluorodeoxyglucose metabolism in the lymph nodes, lungs, liver, spleen and bones. While symptoms of nonchalance and confusion were identified on admission, the patient's serum calcium level was high at 3.87 mmol/l, so a hypercalcemic crisis was confirmed. A biopsy of the right lingual lymph node revealed peripheral T-cell lymphoma, not otherwise specified. The serum calcium level was restored to within the normal range following emergency measures, such as saline rehydration, diuretics, calcitonin and glucocorticoids, and partial remission was achieved following two courses of chemotherapy. The study may improve our present understanding of the diagnosis and treatment of cancer-associated myositis (CAM) and malignancy-associated hypercalcemia.
本研究报告了一例61岁的男性多肌炎患者，其下肢无力加重且反复发热持续了一个月。正电子发射断层扫描/计算机断层扫描显示，淋巴结、肺、肝、脾和骨骼中有多个区域的氟脱氧葡萄糖代谢升高。入院时发现患者有冷漠和意识模糊的症状，其血清钙水平高达3.87 mmol/l，因此确诊为高钙血症危象。右侧舌淋巴结活检显示为外周T细胞淋巴瘤，其他方面未作特殊说明。采取生理盐水补液、利尿剂、降钙素和糖皮质激素等紧急措施后，血清钙水平恢复到正常范围内，经过两个疗程的化疗后病情部分缓解。该研究可能会提高我们目前对癌症相关性肌炎（CAM）和恶性肿瘤相关性高钙血症的诊断和治疗的认识。
