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Case Reports
. 2016 Apr 26:2016:bcr2015213954.
doi: 10.1136/bcr-2015-213954.

Hypophosphataemia due to FGF-23 producing B cell non-Hodgkin's lymphoma

Jan H Elderman  1 , Marike Wabbijn  1 , Felix de Jongh  1
Affiliations
Case Reports

Hypophosphataemia due to FGF-23 producing B cell non-Hodgkin's lymphoma

Jan H Elderman et al. BMJ Case Rep. .

Abstract

Oncogenic osteomalacia (or tumour-induced osteomalacia) is a rare paraneoplastic syndrome caused by overproduction of fibroblastic growth factor 23 (FGF-23) by tumours. Excessive production of FGF-23 can lead to severe, symptomatic hypophosphataemia. The majority of cases have been associated with benign tumours of bone or soft tissue, such as haemangiopericytomas or other neoplasms of mesenchymal origin. We present a case of a 68-year-old woman with an FGF-23 producing B cell non-Hodgkin's lymphoma. Treatment with immunochemotherapy resulted in normalisation of serum FGF-23 and phosphate levels.

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Figures

Figure 1
Figure 1
Fludeoxyglucose-positron emission tomography (right) and octreotide scintigraphy (left) showing markedly increased uptake in the right proximal humerus and neck of the left femur without pathological masses on CT scan.
Figure 2
Figure 2
Biopsy of the intraoral lesion showing diffuse large B cell non-Hodgkin's lymphoma (left). Additional immunohistochemical staining showing extensive expression of fibroblastic growth factor-23 in the cytoplasm of malignant B cells (right).
See this image and copyright information in PMC

References

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