Intrathoracic Extramedullary Hematopoiesis Research Articles

Computed tomography of intrathoracic extramedullary haematopoiesis occurring as a complication of osteopetrosis

Intrathoracic extramedullary haematopoiesis occurring as a complication of osteopetrosis is uncommon. The combination of classic plain film and CT findings should suggest the diagnosis, which can be non-invasively confirmed with bone marrow scintigraphy.

Clinical usefulness of In-111 chloride and Tc-99m Sn colloid scintigraphy in the diagnosis of intrathoracic extramedullary hematopoiesis

We report a case of intrathoracic extramedullary hematopoiesis associated with hemolytic anemia. While the paravertebral localization of the lesions demonstrated on CT and MRI was suspicious of intrathoracic extramedullary hematopoiesis, In-111 chloride and Tc-99m Sn colloid bone marrow scintigraphies showing a bone marrow element of the lesion were useful to confirm the diagnosis.

Hematopoiese extramedular intratorácica: relato de um caso

Os autores relatam o caso de um paciente do sexo masculino, de 40 anos de idade, portador de anemia falciforme, que desenvolveu a forma intratorácica de hematopoiese extramedular, apresentando lesões expansivas com densidade de partes moles, localizadas posteriormente, nas goteiras paravertebrais, na radiologia convencional. A tomografia computadorizada do tórax demonstrou massas bem delimitadas, de contornos lobulados, com densidade heterogênea à custa de áreas de tecido gorduroso e de densidade de partes moles, localizadas no terço inferior das goteiras paravertebrais. Os pulmões tinham coeficientes de atenuação preservados. A tomografia computadorizada de abdome revelou importante aumento da densidade e do volume do fígado, atribuídos à hemossiderose, e baço atrófico e calcificado devido a infartos esplênicos de repetição.

Extramedullary hematopoiesis as differential mediastinal space-occupying lesion diagnosis

Intrathoracic extramedullary hematopoiesis is a rare disease in the differential diagnosis of mediastinal masses. It is suggested that asymptomatic masses should not be treated. A correct diagnosis can thus help to avoid an operation. The aim of this case report is to draw attention to this phenomenon as a cause of mediastinal masses and to provide information about diagnostic facilities available. We report the case of a 53-year-old male patient with hereditary spherocytosis as well as the case of a 59-year-old male patient with pyruvate kinase deficiency who showed intrathoracic paravertebral masses, that were identified in the first case by video-assisted thoracoscopic intervention (VATS) and in the second case by thoracotomy as a region of extramedullary hematopoiesis.

Extramedullary hematopoiesis simulating posterior mediastinal tumors

We report the case of a patient with intrathoracic extramedullary hematopoiesis presenting as a posterior mediastinal tumor in response to chronic hemolytic anemia. Noninvasive studies including chest roentgenograms, computed tomographic scans, magnetic resonance images, and nuclear scans can establish the diagnosis in most cases. In equivocal cases, transthoracic needle biopsy and open biopsy should be considered. Surgical resection is recommended only for patients with symptoms of compression.

MR findings in hereditary spherocytosis

The magnetic resonance findings of intrathoracic extramedullary hematopoiesis associated with bone marrow reconversion, and reticuloendotelial hemosiderosis in a 50-years-old are reported. Radiologic finding of extramedullary hematopoiesis was the first step to the diagnosis of previously unknown hereditary spherocytosis.

Gaucher's Disease: An Unusual Cause of Intrathoracic Extramedullary Hematopoiesis

A thoracic paravertebral mass in an asymptomatic woman with type 1 Gaucher's disease proved to be due to extramedullary hematopoiesis. This is, to our knowledge, the first case of intrathoracic extramedullary hematopoiesis reported with Gaucher's disease.

Massive Hemothorax Associated with Intrathoracic Extramedullary Hematopoiesis Involving the Pleura

Intrathoracic extramedullary hematopoiesis rarely involves the pleura and is usually asymptomatic. We report a 73-year-old woman with myelofibrosis who had pleural involvement with extramedullary hematopoietic tissue that produced a massive hemothorax. Before the diagnosis of extramedullary hematopoietic tissue was established, sclerosis with tetracycline was attempted, which accelerated pleural bleeding and required surgical evacuation. The bleeding was ultimately controlled by low-dose radiation therapy.

Intrathoracic Extramedullary Hematopoiesis Secondary to B12 and Folate Deficiency

Intrathoracic extramedullary hematopoiesis is an unusual condition, usually associated with congenital hemolytic anemias. We present a rare case due to vitamin B12 and folate deficiency diagnosed by CT-guided biopsy.

INTRATHORACIC EXTRAMEDULLARY HEMATOPOIESIS SIMULATING MEDIASTINAL TUMOR IN A CASE OF HEMOLYTIC ANEMIA (SPHEROCYTOSIS)

Intrathoracic extramedullary hematopoiesis simulating mediastinal tumor in a 64-year-old female with hemolytic anemia (spherocytosis) is reported.The patient was admitted to the Ryukyu University Hospital on August 26, 1986 for mediastinal tumor surgery. Her past medical history revealed that 10 years prior to admission, she had been operated on for gallstones. At that time she had been diagnosed as having hemolytic anemia (spherocytosis). On admission, the chest X-ray showed a right mediastinal tumor. CT studies of the chest demonstrated a large hyperdense mass (49.7 HU) arising from the right paravertebral space and extending from the 6th to the 12th paravertebral body with well-defined margins. The tumor was 8.5×8.5×4.5 cm in size and 60 g in weight. It appeared as a redbrown encapsulated soft mass mimicking hemangioma. Histologically, it was composed of extensive hematopoietic tissue and sparse fatty tissue.The patient's postoperative course was uneventful. Her Hgb was 8.6 mg/dl on discharge, and returned to 10.6 mg/dl one year later.

Intrathoracic extramedullary hematopoiesis simulating anterior mediastinal tumor

Intrathoracic extramedullary hematopoiesis is a rare tumor occurring predominantly in the posterior mediastinum, most commonly in patients with congenital hemolytic anemias. The first reported case of this entity's occurring in the anterior mediastinum is described in a 68-year-old man with an incompletely characterized anemia. Definitive diagnosis was established only after median sternotomy and removal of the tumor.

INTRATHORACIC EXTRAMEDULLARY HEMATOPOIESIS.

Bone marrow production of the cellular elements of blood may be supplemented by foci of extramedullary hematopoiesis. This compensatory mechanism takes place when curtailed production or increased demand interferes with normal hematopoiesis. Extramedullary hematopoiesis has occurred in anemias associated with thalassemia, pernicious anemia, hereditary spherocytosis, osteosclerosis where the bone marrow has been replaced with tumor cells (i.e., carcinoma, Hodgkin's disease, lymphoma, and leukemia), hyperparathyroidism, and erythremia (9). Extramedullary hematopoiesis has been reported in the liver, spleen, hilus of kidney, thymus, adrenal, appendix, lymph node, dura mater, broad ligament, prostate, sciatic nerve, breast, and in the paraspinal region of the thorax (9). Nine cases of intrathoracic extramedullary hematopoiesis have been proved at autopsy (1–5, 7, 8, 10, 12) and 3 at biopsy (6, 9, 11). This is the tenth autopsy-proved case and the first in a patient with sickle-cell anemia. Case Report A 31-year-old Negro male was admitted to Temple University Hospital on Oct. 3, 1963, with a chief complaint of increasing hoarseness during the three months prior to admission. He had homozygous sickle-cell anemia. The review of symptoms disclosed an increasing dyspnea for the past several years associated with intermittent ankle edema. Physical examination showed an underdeveloped Negro male in no acute distress. The sclerae were not icteric. A positive hepatojugular reflex was elicited. The heart was enlarged. A Grade IV pansystolic murmur was heard. The pertinent laboratory findings were an initial hemoglobin of 3.8 g per 100 ml, hematocrit 12 per cent, and a white count of 7,500 with a normal differential. There were 151 nucleated red blood cells per 100 white cells. The thrombocyte count was 81,000. The red blood cell count was 1.3 million, and the peripheral smear showed target cells, a moderate number of sickle cells, and Howell-Jolly bodies. The blood urea nitrogen was 43 mg per 100 ml. Hemoglobin rose to 8.1 g per 100 ml following 3 units of blood, but dropped again to 4.2 g within a short time. Bone marrow aspiration revealed an erythroid hyperplasia with mild maturation arrest and sickle-cell phenomenon. The paper electrophoresis of a blood sample showed a 97.8 per cent hemoglobin S and 2.2 per cent hemoglobin A2 (fetal hemoglobin). Ten per cent of the fetal hemoglobin was alkali-denaturated. At cardiac catheterization, no intracardiac defects were found. The murmur, therefore, was attributed to the anemia. Roentgen examination of the chest revealed generalized cardiomegaly with no specific chamber enlargement. There was a smooth, right, posterior paraspinal soft-tissue density from T-8 to T-11 with a small extension to the left of the spine (Fig. 1), but without calcification or evidence of an associated osseous lesion. The density did not change in the lateral decubitus position.