Hirano Shiho, Iwakoshi Akari, Imahashi Nobuhiko, Sakai Akihiro, Hirano Daiki, Suzuki Yasuhiro, Adachi Tatsuya, Nagai Hirokazu, Iida Hiroatsu
Department of Hematology, National Hospital Organization Nagoya Medical Center.
Department of Pathology, National Hospital Organization Nagoya Medical Center.
Rinsho Ketsueki. 2023;64(7):608-613. doi: 10.11406/rinketsu.64.608.
A 69-year-old male patient was referred to our hospital for further examination of hypoglycemia, splenomegaly, and para-aortic lymphadenopathy. The patient was diagnosed with diffuse large B-cell lymphoma (DLBCL) by para-aortic lymph node biopsy. Hypoglycemia was refractory to glucose supplementation but improved shortly after chemotherapy. This situation suggested that hypoglycemia was caused by lymphoma. We compared the expression levels of glyceraldehyde 3-phosphate dehydrogenase, a glycolytic enzyme whose expression is positively correlated with the glycolytic activity of cells, between the current case and two cases of DLBCL without hypoglycemia to explore the possibility that hypoglycemia was due to intense glucose consumption by lymphoma cells through their high glycolytic activity. Results revealed substantially higher expression levels of glyceraldehyde 3-phosphate dehydrogenase in the current case than in DLBCL without hypoglycemia, suggesting that the glycolytic pathway was enhanced in the current case. These results implied that intense glucose consumption by lymphoma cells through their high glycolytic activity causes hypoglycemia.
一名69岁男性患者因低血糖、脾肿大和主动脉旁淋巴结病被转诊至我院进行进一步检查。通过主动脉旁淋巴结活检，该患者被诊断为弥漫性大B细胞淋巴瘤（DLBCL）。低血糖对补充葡萄糖治疗无效，但化疗后不久有所改善。这种情况提示低血糖是由淋巴瘤引起的。我们将该病例与两例无低血糖的DLBCL病例进行比较，检测了甘油醛-3-磷酸脱氢酶（一种糖酵解酶，其表达与细胞糖酵解活性呈正相关）的表达水平，以探讨低血糖是否是由于淋巴瘤细胞通过其高糖酵解活性大量消耗葡萄糖所致。结果显示，该病例中甘油醛-3-磷酸脱氢酶的表达水平显著高于无低血糖的DLBCL病例，提示该病例中糖酵解途径增强。这些结果表明，淋巴瘤细胞通过其高糖酵解活性大量消耗葡萄糖导致低血糖。
