Subject(s)
Calcinosis/pathology , Down Syndrome/complications , Hand Dermatoses/pathology , Biopsy , Calcinosis/etiology , Child , Female , Hand Dermatoses/etiology , HumansSubject(s)
Cell Division/drug effects , Inhibins/pharmacology , Neuroblastoma/drug therapy , Neurofibromatosis 1/drug therapy , Skin Neoplasms/drug therapy , Activins , Adult , Dose-Response Relationship, Drug , Humans , Male , Neuroblastoma/pathology , Neurofibromatosis 1/pathology , Skin Neoplasms/pathology , Tumor Cells, CulturedABSTRACT
We report on a 61-year-old woman with coexisting early stage primary gastric plasmacytoma and sarcoidosis with hypercalcaemia. Laboratory data on admission showed hypercalcaemia, with 12.8 mg/dl, parathyroid hormone-related peptide (PTHrP) 1.2 pmol/l, C-PTHrP 69.5 pmol/l, and 1,25-dihydroxyvitamin D3 46.7 pg/ml. Neoplastic plasma cells proliferated in the propria mucosa of the stomach, showed a monoclonal immunoglobulin of cytoplasmic IgA (lambda light chain) and were positive for leucocyte common antigen and epithelial membrane antigen on paraffin section prepared from a stomach biopsy specimen. Russel bodies were present, as were crystals. Abundant sarcoid granulomas were observed in many of the regional lymph nodes around the stomach and in the dermis of a skin nodule. The patient underwent subtotal gastrectomy with administration of antimyeloma chemotherapy. We suggest that the hypercalcaemia in this patient was due to PTHrP production by neoplastic plasma cells.
