Adult T-cell Leukemia-lymphoma associated with Metastatic Calcification and Acute Pancreatitis under Hypercalcemic Condition

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概要

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• Metastatic calcification due to hypercalcemia in adult Tcell leukemia-lymphoma (ATL) associated with osteolytic change for activation of osteoclasts are reported. These cases of serum calcium were at a high level, 15.1 and 19.4 mg/dl (normal range 8.4-10.4 mg/dl). Metastatic calcification was detected in the tubules of kidneys, in the pulmonary alveolar septa of lungs, in the myocardium, in the muscular layer of stomach, in the lower portion of media of aorta, in the mucosa of stomach, in the tubules of testis, and in the liver by von Kossa's silver nitrate method for calcium. Scattered osteoclasts were seen around the cortex of the bone. ATL cells stained with parathyroid hormone-related protein (PTHrP) by immunohistochemical procedure. Thus, PTHrP is an important bone resorption-stimulating factor of hypercalcemia in ATL. We have investigated the incidence of acute pancreatitis in ATL, and in the other diseases. Of the 317,325 autopsy cases, 632 were ATL; the numbers of the acute pancreatitis cases of them were 1,833 (0.58%) and 25 (4.0%), respectively. The odds ratio from 2 x 2 table is 7.17 and Peason's Chi-square statistics with one degree of freedom is 126, which is highly significant. Therefore, it was suggested that there is a close correlation between acute pancreatitis and hypercalcemia in patients with ATL. We proposed a new theory for the correlation between acute pancreatitis and hypercalcemia in ATL that all the hypercalcemic patiens exhibited high levels of nephrogenous cyclic adenosine monophosphate (NcAMP) stimulating pancreatic secretion in the extralobular ductal system of the pancreas and thus resuling in acute pancreatitis due to occlusion of the pancreatic duct.

• 長崎大学の論文

著者

• Itakura Hideyo

  Department Of Pathology Institute Of Tropical Medicine Nagasaki University

• Hideyo Itakura

  Department Of Pathology Institute Of Tropical Medicine Nagasaki University Nagasaki Japan

• Senba Masachika

  Department Of Pathology Institute For Tropical Medicine Nagasaki University

• Masachika Senba

  Department Of Pathology Institute Of Tropical Medicine Nagasaki University Nagasaki Japan

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