Plasma-Cell Granuloma Producing Calcitriol and Hypercalcemia
- MARY ALICE HELIKSON, M.D.;
- ANN D. HAVEY, M.D.;
- JOSEPH E. ZERWEKH, Ph.D.;
- NEIL A. BRESLAU, M.D.; and
- DAVID W. GARDNER, M.D.
Abstract
A teenage boy presented with hypercalcemia and a large intrathoracic mass. Results of an extensive evaluation, including normal findings on parathyroid hormone and urinary 3 , 5-cyclic adenosine monophosphate assays, failed to explain his hypercalcemia. During surgery, a large plasma-cell granuloma of the right middle and lower lobes was resected. Within 2 weeks, serum calcium levels returned to normal. Serum calcitriol (1,25-dihydroxyvitamin D3) levels were elevated before surgery and decreased to normal afterward, correlating with the serum calcium level. Homogenates of the plasma-cell granuloma synthesized a compound indistinguishable from calcitriol.
Article and Author Information
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▸From the Departments of Surgery, Pathology, and Medicine, University of Mis-souri-Columbia Health Sciences Center, Columbia, Missouri; and the Department of Medicine, Southwestern Medical School, Dallas, Texas.
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Grant support: by grant R01-AM26253 from the National Institutes of Health.
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▸Requests for reprints should be addressed to Mary Alice Helikson, M.D.; Department of Surgery, Room N307A, University of Missouri-Columbia Health Sciences Center; Columbia, MO 65212.
- © 1986 American College of Physicians
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