Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Extramedullary hematopoiesis
- Radiologic Findings
- Chest PA radiograph (Figure 1) shows a lobulated contour on the both side of paravertebral stripes. It also demonstrates marked cardiomegaly with pericardial effusion and collapse of the RML. The chest CT images (Figure 2-3) reveal cardiomegaly with pericardial effusion, homogeneously enhancing paraspinal masses, left side of T6-7 and both sides of T8-10 vertebral level. There are multiple GB stones with hepatosplenomegaly (Figure 4). She had an autoimmune hemolytic anemia and underwent splenectomy
- Brief Review
- Extramedullary hematopoiesis (EMH) is the proliferation of hematopoietic cells outside of the bone marrow in response to production of too few blood cells to satisfy the body’s demand.
Intrathoracic EMH may manifest as a paraosseous mass, interstitial pulmonary abnormality, pleural mass, or hemothorax, either alone or in combination.
Mediastinal lesions most commonly occur in the posterior mediastinum due to herniation of myeloid tissue through the thin cortical bone of the posterior ribs and/or activation of extramyeloid hematopoietic cells. The paraspinal masses and rib expansion are the most common manifestation of intrathoracic EMH.
The paraspinal masses have to be differentiated from lymphadenopathy and neurogenic tumors. Cases of EMH involving the pulmonary interstitium mimick an inflammatory or neoplastic diffuse interstitial process and have occasionally resulted in cardiopulmonary insufficiency. EMH usually regresses or disappears after treatment with blood transfusion and hydroxyurea, splenectomy in cases of spherocytosis, or radiation therapy.
- References
- 1.Choi H, David CL, Katz RL, and Podoloff DA. Case 69: Extramedullary Hematopoiesis Radiology 2004; 231: 52-56.
Gupta P, Naran A, Auh YH, and Chung JS. Focal Intrahepatic Extramedullary Hematopoiesis Presenting as Fatty Lesions Am. J. Roentgenol. 2004; 182: 1031 - 1032.
2.Chang CC, WU MM, Chao C, Vang VT, Tyan YS. Focal Tumor-like Splenic Extramedullary Hematopoiesis: a case report Chin J Radiol 2004; 29: 105-108.
3.Yahya M. Berkmen and Benjamin A. Zalta. Case 126: Extramedullary Hematopoiesis Radiology 2007; 245: 905-908
- Keywords
- mediastinum, metabolic ans storage,