Yabe Masahiro, Abe Takashi, Yamaga Saori, Ozaki Seiga, Tomiyama Katsuhiro, Hashidate Hideki
Department of General Internal Medicine, Niigata City General Hospital, Niigata, Japan.
Department of Hematology, Niigata City General Hospital, Niigata, Japan.
Eur J Case Rep Intern Med. 2025 Apr 23;12(5):005406. doi: 10.12890/2025_005406. eCollection 2025.
Hypercalcaemia in intravascular large B-cell lymphoma (IVLBCL) is extremely rare, occurring more often in other non-Hodgkin's lymphomas (NHL).
A 68-year-old man was admitted with a fever of unknown origin, mild disturbance of consciousness and respiratory failure. Laboratory findings showed hypercalcaemia with elevated parathyroid hormone-related protein (PTHrP) and decreased intact parathyroid hormone and 1,25-dihydroxyvitamin D. The patient was diagnosed with IVLBCL via random skin biopsy. Chemotherapy resulted in complete remission and normalised PTHrP levels.
More than half of all cases of hypercalcaemia in NHL are not associated with PTHrP or 1,25-dihydroxyvitamin D, and the cause of the hypercalcaemia is unknown. However, PTHrP levels are elevated in most cases of IVLBCL with hypercalcaemia, which may present as humoral hypercalcaemia of malignancy.
Intravascular large B-cell lymphoma, a rare, clinically aggressive type of B-cell non-Hodgkin's lymphoma, is prone to central nervous system disturbances, including altered consciousness.Hypercalcaemia, which causes impaired consciousness, is extremely rare in intravascular large B-cell lymphoma, occurring more often in other non-Hodgkin's lymphomas.Parathyroid hormone-related protein is elevated in most cases of intravascular large B-cell lymphoma with hypercalcaemia, which may present as humoral hypercalcaemia of malignancy.
血管内大B细胞淋巴瘤（IVLBCL）中的高钙血症极为罕见，在其他非霍奇金淋巴瘤（NHL）中更为常见。
一名68岁男性因不明原因发热、轻度意识障碍和呼吸衰竭入院。实验室检查结果显示高钙血症，甲状旁腺激素相关蛋白（PTHrP）升高，完整甲状旁腺激素和1,25-二羟维生素D降低。通过随机皮肤活检，该患者被诊断为IVLBCL。化疗导致完全缓解，PTHrP水平恢复正常。
NHL中超过一半的高钙血症病例与PTHrP或1,25-二羟维生素D无关，高钙血症的原因尚不清楚。然而，在大多数伴有高钙血症的IVLBCL病例中，PTHrP水平升高，这可能表现为恶性肿瘤性体液性高钙血症。
血管内大B细胞淋巴瘤是一种罕见的、临床侵袭性的B细胞非霍奇金淋巴瘤，易发生中枢神经系统紊乱，包括意识改变。导致意识障碍的高钙血症在血管内大B细胞淋巴瘤中极为罕见，在其他非霍奇金淋巴瘤中更为常见。在大多数伴有高钙血症的血管内大B细胞淋巴瘤病例中，甲状旁腺激素相关蛋白升高，这可能表现为恶性肿瘤性体液性高钙血症。
