[Peripheral blood involvement accompanied with hypercalcemia in the malignant lymphoma of iliac bone]

We reported a rare case of non-Hodgkin's lymphoma of iliac bone which developed peripheral blood involvement associated with hypercalcemia. 42-year-old man was admitted to Fukui Medical School Hospital because of right iliac bone pain. An X-ray film of the pelvis disclosed the osteolytic change of right iliac bone. A CT scan of the pelvis showed soft tissue density tumors involved bilateral iliac bone. He had no superficial lymphadenopathy or organomegaly. Examination of peripheral blood and bone marrow did not show any abnormalities. Monoclonal immunoglobulin was not detected in serum. Examination of biopsied specimens from iliac bone tumor showed infiltration of round cells. Immunocytochemical analysis showed only MT-1 positive. He was treated with combination chemotherapy of vindesine, cyclophosphamide, prednisolone and pirarubicin followed by radiation therapy. But, there was no significant response. Following radiation therapy, he developed coma. Serum calcium was 9.8 mEq/l. The pathologic immature cells were found in peripheral blood. The bone marrow aspirates showed 63% pathologic cells. These cells expressed CD19, CD20, HLA-DR antigens. He was diagnosed as having leukemic non-Hodgkin's lymphoma, B-cell type, and was treated with combination chemotherapy. But he died of systemic fungal infection.