ABSTRACT
While the concept of developing hypocholesterolemia during myeloma or lymphoma is not unusual, the existence of developing hyperlipemia is rare. The authors report the case of a sixty-one year old diabetic patient treated by oral medication. This patient does not have a family history of hyperlipemia. He was hospitalized for degradation of his general condition, and a pain of the right shoulder and bilateral pleural effusion. A major hyperlipidemia [total cholesterol = 13.5 mmol/l, triglycerides = 16.8 mmol/l] was noted during his hospitalization and persisted in spite of a fibrate treatment and a controlled diabetes. The radiography of the upper right limb showed lytic images of the extremity of the humerus. The thoracic CT scan showed bilateral pleural effusion and a hyperdense paravertebral image of ganglion metastasis. The myelograme and the pleural biopsies showed a malignant non hodgkin lymphoma. An immunosuppressor treatment was prescribed resulting in a spectacular improvement of the hyperlipidemia since the first chemotherapy. This is probably an autoimmune hyperlipidemia associated with a lymphoma. Further investigations like the study of the lipoprotein lipase activity, the search of antibodies related to the apo E or the apo B would be useful in order to confirm this assumption