Osseous metaplasia in diffuse large B‐cell lymphoma of the kidney

Abstract

A 57-year-old female with a history of diffuse large B-cell lymphoma (DLBCL) presented with a renal mass. Microscopic analysis of the nephrectomy specimen revealed DLBCL, confirmed by immunohistochemical analysis (CD45, CD20, CD3, pan-keratin) and polymerase chain reaction (PCR). Multiple spicules of metaplastic bone were identified within the tumor mass, but not within the uninvolved kidney parenchyma. No evidence of bone or dystrophic calcification was detected on the pre-nephrectomy computerized tomography (CT) scan. To our knowledge, this is the first incidence of osseous metaplasia occurring within DLBCL. The pathogenesis of osseous metaplasia is briefly discussed. Am. J. Hematol. 82:321-324, 2007. V V C 2006 Wiley-Liss, Inc.

Osseous Metaplasia in Castleman's Disease: A Case Report

“…IL-6 is may be the responsible factor. Although this interleukin is considered as a bone resorption factor, [13, 14] it may play a role in bone formation and osteoblast proliferation, too [10, 13]. Also amyloid deposit may be seen in CD [9], and this could be site for osseous metaplasia, but no amyloid deposit was seen in our case.…”

“…According to clinical presentation CD may be unicentric or multicentric [1–6, 9, 10]. The unicentric form is usually of hyaline-vascular type, pauci symptomatic with favorable prognosis and commonly involves the mediastinum [3, 4].…”

“…Among hematologic malignancies, amyloid-producing dyscrasia and diffuse large B-cell lymphoma were reported to produce heterotopic bones [10]. Two theories for this phenomenon are proposed: (i) tumor cells directly differentiate into osteoblasts, (ii) tumor cells secrete substances which induce osteoblastic differentiation in adjacent mesenchymal cells.…”

“…Two theories for this phenomenon are proposed: (i) tumor cells directly differentiate into osteoblasts, (ii) tumor cells secrete substances which induce osteoblastic differentiation in adjacent mesenchymal cells. One of these suggested substances that induce osseous metaplasia in epithelial tumors is bone morphogenic protein (BMP) [10]. BMPs are members of transforming growth factor β (TGF- β ) which stimulates differentiation of mesenchymal cells to osteoblasts through binding to appropriate receptor [11].…”

Lipogranuloma with Osseous Metaplasia in the Breast That Developed after "Bu-Hwang" Oriental Medicine Treatment

“…Osseous metaplasia may develop after trauma, or with a post-traumatic hematoma and soft-tissue tumors, especially slow growing tumors treated with radiation 3. Several cases of osseous metaplasia have been reported that were related to conditions, including tubular adenoma of the colon, diffuse large B-cell lymphoma and amyloid-producing dyscrasia 5,9. Few studies have reported benign breast lesions that were seen as osseous metaplasia 10.…”