{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,1]],"date-time":"2025-11-01T17:17:58Z","timestamp":1762017478719},"reference-count":18,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2010,10,19]],"date-time":"2010-10-19T00:00:00Z","timestamp":1287446400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Case Reports"],"published-print":{"date-parts":[[2010,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Hypercalcemia is the major electrolyte abnormality in patients with malignant tumors. It can be due to localized osteolytic hypercalcemia or elaboration of humoral substances such as parathyroid hormone-related protein from tumoral cells. In hematological malignancies, a third mechanism of uncontrolled synthesis and secretion of 1-25(OH)<jats:sub>2<\/jats:sub>D<jats:sub>3<\/jats:sub> from tumoral cells or neighboring macrophages may contribute to the problem. However, hypercalcemia is quite unusual in patients with B-cell non-Hodgkin's lymphoma.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Case presentation<\/jats:title>\n            <jats:p>An 85-year-old Caucasian woman presented with low grade fever, anorexia, abdominal discomfort and fullness in her left abdomen for the last six months. She was mildly anemic and complained of fatigability. She had huge splenomegaly and was hypercalcemic. After correction of her hypercalcemia, she had a splenectomy. Microscopic evaluation revealed a malignant lymphoma. Her immunohistochemistry was positive for leukocyte common antigen, CD20 and parathyroid hormone-related peptide.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>Immunopositivity for parathyroid hormone-related peptide clearly demonstrates that hypersecretion of a parathyroid hormone-like substance from the tumor had led to hypercalcemia in this case. High serum calcium is seen in only seven to eight percent of patients with B-cell non-Hodgkin's lymphoma, apparently due to different mechanisms. Evaluation of serum parathyroid hormone-related protein and 1-25(OH)<jats:sub>2<\/jats:sub>D<jats:sub>3<\/jats:sub> can be helpful in diagnosis and management. It should be noted that presentation with hypercalcemia has a serious impact on prognosis and survival.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1752-1947-4-330","type":"journal-article","created":{"date-parts":[[2010,10,20]],"date-time":"2010-10-20T06:13:53Z","timestamp":1287555233000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Hypercalcemia and huge splenomegaly presenting in an elderly patient with B-cell non-Hodgkin's lymphoma: a case report"],"prefix":"10.1186","volume":"4","author":[{"given":"Ali AM","family":"Ghazi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hamid","family":"Attarian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shirin","family":"Attarian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Abolghasem","family":"Abasahl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebrahim","family":"Daryani","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ebrahim","family":"Farasat","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marina","family":"Pourafkari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Farrokh","family":"Tirgari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siavash M","family":"Ghazi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kalman","family":"Kovacs","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2010,10,19]]},"reference":[{"key":"1287_CR1","doi-asserted-by":"crossref","first-page":"1952","DOI":"10.1056\/NEJMcpc020023","volume":"347","author":"JK Erban","year":"2004","unstructured":"Erban JK, Tang Z: A 54 year old man with hypercalcemia, renal dysfunction and an enlarged liver. N Engl J Med. 2004, 347: 1952-1960.","journal-title":"N Engl J Med"},{"key":"1287_CR2","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1056\/NEJMcp042806","volume":"352","author":"AF Stewart","year":"2005","unstructured":"Stewart AF: Hypercalcemia associated with cancer. N Engl J Med. 2005, 352: 373-379. 10.1056\/NEJMcp042806.","journal-title":"N Engl J Med"},{"key":"1287_CR3","doi-asserted-by":"publisher","first-page":"709","DOI":"10.7326\/0003-4819-121-9-199411010-00012","volume":"121","author":"M Cox","year":"1994","unstructured":"Cox M, Haddad JG: Lymphoma, hypercalcemia, and the sunshine vitamin. Ann Intern Med. 1994, 121: 709-712.","journal-title":"Ann Intern Med"},{"key":"1287_CR4","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1016\/S0889-8529(05)70154-7","volume":"29","author":"GJ Strewler","year":"2000","unstructured":"Strewler GJ: The parathyroid hormone-related protein. Endocrinol Metab Clin North Am. 2000, 29: 629-645. 10.1016\/S0889-8529(05)70154-7.","journal-title":"Endocrinol Metab Clin North Am"},{"key":"1287_CR5","doi-asserted-by":"publisher","first-page":"638","DOI":"10.7326\/0003-4819-121-9-199411010-00001","volume":"121","author":"JF Seymour","year":"1994","unstructured":"Seymour JF, Gogel RF, Hagemeister FB: Calcitriol production in hypercalcemic and normocalcemic patients with non-Hodgkin lymphoma. Ann Intern Med. 1994, 121: 638-640.","journal-title":"Ann Intern Med"},{"key":"1287_CR6","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1007\/s002770050393","volume":"76","author":"H Uno","year":"1998","unstructured":"Uno H, Shima T, Maeda K: Hypercalcemia associated with parathyroid hormone-related protein produced by B-cell type primary malignant lymphoma of the kidney. Ann Hematol. 1998, 76: 221-224. 10.1007\/s002770050393.","journal-title":"Ann Hematol"},{"issue":"1","key":"1287_CR7","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.ando.2007.10.004","volume":"69","author":"T Amezyane","year":"2008","unstructured":"Amezyane T, Lecoules S, Bordier L, Blade JS, Desrame J, Bechade D, Coutant G, Algayres JP: Humoral hypercalcemia revealing a malignant non Hodgkin lymphoma. Ann Endocrinol (Paris). 2008, 69 (1): 58-62.","journal-title":"Ann Endocrinol (Paris)"},{"key":"1287_CR8","doi-asserted-by":"publisher","first-page":"637","DOI":"10.1136\/jcp.55.8.637-a","volume":"55","author":"G Majumdar","year":"2002","unstructured":"Majumdar G: Incidence and prognostic significance of hypercalcemia in B-cell non Hodgkin's lymphoma. J Clin Pathol. 2002, 55: 637-638. 10.1136\/jcp.55.8.637-a.","journal-title":"J Clin Pathol"},{"key":"1287_CR9","doi-asserted-by":"publisher","first-page":"968","DOI":"10.2169\/internalmedicine.31.968","volume":"31","author":"S Wada","year":"1992","unstructured":"Wada S, Kitamura H, Matsaura Y: Parathyroid hormone-related protein as a cause of hypercalcemia in a B-cell type malignant lymphoma. Internal Medicine. 1992, 31: 968-972. 10.2169\/internalmedicine.31.968.","journal-title":"Internal Medicine"},{"key":"1287_CR10","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1002\/(SICI)1096-8652(199610)53:2<144::AID-AJH18>3.0.CO;2-F","volume":"53","author":"T Hanihara","year":"1996","unstructured":"Hanihara T, Takahashi T: Parathyroid hormone-related protein-associated hypercalcemia in probable intravascular lymphoma of B-cell type. Am J Hematol. 1996, 53: 144-146. 10.1002\/(SICI)1096-8652(199610)53:2<144::AID-AJH18>3.0.CO;2-F.","journal-title":"Am J Hematol"},{"key":"1287_CR11","doi-asserted-by":"publisher","first-page":"257","DOI":"10.1136\/jcp.51.3.257","volume":"51","author":"L Ranganath","year":"1998","unstructured":"Ranganath L, Jamal H, Jones L: Value of assessing parathyroid hormone-like activity in a case of extreme hypercalcaemia. J Clin Pathol. 1998, 51: 257-258. 10.1136\/jcp.51.3.257.","journal-title":"J Clin Pathol"},{"key":"1287_CR12","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1136\/pgmj.75.889.672","volume":"75","author":"A Daroszerski","year":"1999","unstructured":"Daroszerski A, Bucknall RC, Chu P: Severe hypercalcaemia in B-cell lymphoma: combined effects of PTH-rP, IL-6 and TNF. Postgrad Med J. 1999, 75: 672-674. 10.1136\/pgmj.75.889.672.","journal-title":"Postgrad Med J"},{"key":"1287_CR13","first-page":"204","volume":"140","author":"B Knobel","year":"2001","unstructured":"Knobel B, Sommer I, Petchenko P: Malignant humoral hypercalcemia associated with angiotropic large B cell lymphoma. Harefuah. 2001, 140: 204-206.","journal-title":"Harefuah"},{"key":"1287_CR14","doi-asserted-by":"publisher","first-page":"167","DOI":"10.3143\/geriatrics.40.167","volume":"40","author":"H Ota","year":"2003","unstructured":"Ota H, Azuma K, Horiuchi T: An elderly case of non-Hodgkin's lymphoma with hypercalcemia. Nippon Ronen Igakkai Zasshi. 2003, 40: 167-171. 10.3143\/geriatrics.40.167.","journal-title":"Nippon Ronen Igakkai Zasshi"},{"key":"1287_CR15","first-page":"119","volume":"91","author":"B Schottker","year":"2006","unstructured":"Schottker B, Heinz W, Weissinger F: Parathyroid hormone related protein-associated hypercalcemia in a patient with CLL type low grade leukemic B cell lymphoma. Hematologica. 2006, 91: 119-122.","journal-title":"Hematologica"},{"key":"1287_CR16","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1002\/ajh.20559","volume":"81","author":"H Takasaki","year":"2006","unstructured":"Takasaki H, Kanamori H, Takabayashi M: Non-Hodgkin's lymphoma presenting as multiple bone lesions and hypercalcemia. Am J Hematol. 2006, 81: 439-442. 10.1002\/ajh.20559.","journal-title":"Am J Hematol"},{"key":"1287_CR17","doi-asserted-by":"publisher","first-page":"1790e7","DOI":"10.1016\/j.urology.2007.03.076","volume":"70","author":"T Klatte","year":"2007","unstructured":"Klatte T, Said JW, Belldegrun AS: Differential diagnosis of hypercalcemia in renal malignancy. Urology. 2007, 70: 1790e7-1790e8. 10.1016\/j.urology.2007.03.076.","journal-title":"Urology"},{"key":"1287_CR18","doi-asserted-by":"publisher","first-page":"5825","DOI":"10.1200\/JCO.2007.13.4908","volume":"25","author":"MA Habra","year":"2007","unstructured":"Habra MA, Weaver EJ, Vance Prewitt P: Primary cutaneous large B cell lymphoma of the leg and acute hypercalcemia. J Clin Oncol. 2007, 25: 5825-5826. 10.1200\/JCO.2007.13.4908.","journal-title":"J Clin Oncol"}],"container-title":["Journal of Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1752-1947-4-330.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1752-1947-4-330\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1752-1947-4-330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1752-1947-4-330.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T05:50:13Z","timestamp":1630475413000},"score":1,"resource":{"primary":{"URL":"https:\/\/jmedicalcasereports.biomedcentral.com\/articles\/10.1186\/1752-1947-4-330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,10,19]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2010,12]]}},"alternative-id":["1287"],"URL":"https:\/\/doi.org\/10.1186\/1752-1947-4-330","relation":{},"ISSN":["1752-1947"],"issn-type":[{"value":"1752-1947","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,10,19]]},"assertion":[{"value":"23 October 2009","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2010","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"19 October 2010","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"330"}}