Bains Ashish, Covas Pedro, Timofeeva Olga, Bromberg Michael
Department of Pathology and Laboratory Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA, USA.
Department of Internal Medicine, George Washington University, Washington, DC, USA.
Case Rep Hematol. 2021 Apr 28;2021:5525721. doi: 10.1155/2021/5525721. eCollection 2021.
Hypercalcemia in malignancy is associated with multiple mechanisms and occurs in up to 20-30% of cancer patients. We report a case of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL) associated with hypercalcemia and an elevation in parathyroid hormone-related peptide (PTHrP) in the setting of a Richter transformation. Real-time reverse transcriptase PCR on lymph node biopsy specimens obtained before and after transformation showed an 8-fold increase in PTHrP mRNA levels and about 2-fold decrease in the levels of its cognate receptor PTHR1. The findings of this case suggest that parathyroid hormone-related peptide might be useful in monitoring a specific group of patients with SLL/CLL who develop hypercalcemia during the course of their disease and could suggest an autocrine-like mechanism involving PTHrP in Richter transformation.
恶性肿瘤中的高钙血症与多种机制相关，在高达20%-30%的癌症患者中出现。我们报告一例小淋巴细胞淋巴瘤/慢性淋巴细胞白血病（SLL/CLL），在Richter转化情况下伴有高钙血症和甲状旁腺激素相关肽（PTHrP）升高。对转化前后获得的淋巴结活检标本进行实时逆转录酶PCR显示，PTHrP mRNA水平增加了8倍，其同源受体PTHR1水平下降了约2倍。该病例的发现表明，甲状旁腺激素相关肽可能有助于监测特定组在疾病过程中发生高钙血症的SLL/CLL患者，并可能提示Richter转化中涉及PTHrP的自分泌样机制。
