Metastatic calcification due to hypercalcemia in adult T-cell leukemia-lymphoma (ATLL)

Four cases of metastatic calcification due to hypercalcemia in adult T-cell leukemia-lymphoma (ATLL) are reported. Serum calcium was at high levels, 15.4-19.4 mg/dl (normal range 8.4-10.4 mg/dl). In our cases, metastatic calcification was detected by v. Kossa's silver nitrate method for calcium in tubules of kidneys (100%), pulmonary alveolar septa of lungs (100%), myocardium (75%), muscular layer of stomach (50%), lower portion of aortic media (50%), gastric mucosa (25%), testicular tubules (25%), and in the liver (25%). Scattered osteoclasts were seen around the cortex of the bone. Therefore, hypercalcemia in ATLL may have been caused by bone-resorption-stimulating factors which promote differentiation of osteoclast cells, resulting in calcium increase in the serum.