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[Extranodal non-Hodgkin's lymphoma associated with systemic bone metastasis and secondary myelofibrosis].

Authors
  • Kasahara, K1
  • Takahashi, T
  • Oka, T
  • Yamamoto, M
  • Sirata, T
  • Idogawa, M
  • Naeshiro, M
  • Hayashi, T
  • Adachi, M
  • Hinoda, Y
  • Imai, K
  • 1 First Department of Internal Medicine, Sapporo Medical University School of Medicine.
Type
Published Article
Journal
[Rinsho ketsueki] The Japanese journal of clinical hematology
Publication Date
December 1998
Volume
39
Issue
12
Pages
1180–1184
Identifiers
PMID: 10028851
Source
Medline
License
Unknown

Abstract

A 68-year-old woman was admitted in March 1997 because of lumbago, fever, vomiting, and general malaise. Laboratory data disclosed anemia and severe hypercalcemia (7.7 mEq/l). Multiple osteolytic lesions were detected in the patient's vertebra, pelvis, and bilateral tibia by x-ray films and 99mTc bone scintigrams. Bone marrow aspiration sample was not obtained due to dry tap. Marked myelofibrosis and proliferation of lymphoid cells were revealed by a bone marrow biopsy specimen. Immunohistochemical analysis showed that cells in the biopsy specimen were positive for L-26 and LCA, but not for UCHL-1. Gastrointestinal endoscopic examination found multiple polypoid lesions in the stomach; biopsy specimens of the lesion tissue disclosed invasion by B lymphoid cells. A diagnosis of diffuse large B cell lymphoma was thus made. THP-COP chemotherapy was performed, but only minimal response was obtained. Lymphoma cells subsequently invaded the brain stem, and the patient eventually died of respiratory failure.

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