MRI appearances of extramedullary haematopoiesis presenting with cauda equina syndrome in sickle cell disease

Abstract

Extra-medullary haematopoiesis (EMH) is the physiological response to inadequate blood cell production. The process is commonly seen in the context of chronic haemoglobinopathies and infiltrative marrow disorders, and predominantly takes place within the liver, spleen, and paravertebral regions of the thorax.1 Less commonly, haematopoiesis can also occur in other locations including, rarely, within the spine. This report documents the extremely rare case of such “spinal” EMH presenting with cauda equina syndrome, and describes for the first time the magnetic resonance imaging (MRI) appearances of spinal EMH associated with sickle cell disease (SCD).