Extramedullary hematopoiesis in the adrenal gland is a rare physiologic compensatory event in many haematologic diseases.
For a general discussion on this subject, please refer to the main article on extramedullary hematopoiesis.
Extramedullary hematopoiesis in the adrenal gland is uncommon 2. Instead, it occurs most commonly in the spleen, liver, and lymph nodes and less frequently in the lung, pleura, breast, thymus, small bowel, and central nervous system 1.
The adrenal glands might be involved unilaterally or bilaterally 4. Although rare, there are few reports describing extramedullary hematopoiesis in the adrenal gland in patients with thalassemia 3.
The exact mechanism of extramedullary hematopoiesis in the adrenal gland is unknown. Several hypotheses include 5:
- adrenal gland has hematopoietic capacity during the fetal period and extramedullary hematopoiesis may develop from primitive rests
- embolization of hematopoietic stem cells in adrenal gland may occur
- there may be chronic hypoxia 4,6
- 1. Karami H, Kosaryan M, Taghipour M, Sharifian R, Aliasgharian A, Motalebi M. Extramedullary hematopoiesis presenting as a right adrenal mass in a patient with Beta thalassemia. Nephro-urology monthly. 6 (5): e19465. doi:10.5812/numonthly.19465 - Pubmed
- 2. Georgiades CS, Neyman EG, Francis IR, Sneider MB, Fishman EK. Typical and atypical presentations of extramedullary hemopoiesis. AJR. American journal of roentgenology. 179 (5): 1239-43. doi:10.2214/ajr.179.5.1791239 - Pubmed
- 3. Banerji JS, Kumar RM, Devasia A. Extramedullary hematopoiesis in the adrenal: Case report and review of literature. Canadian Urological Association journal = Journal de l'Association des urologues du Canada. 7 (5-6): E436-8. doi:10.5489/cuaj.1389 - Pubmed
- 4. Porcaro AB, Novella G, Antoniolli SZ, Martignoni G, Brunelli M, Curti P. Adrenal extramedullary hematopoiesis: report on a pediatric case and update of the literature. International urology and nephrology. 33 (4): 601-3. Pubmed
- 5. Azarpira N, Heidari Esfahani M, Paydar S. Extramedullary hematopoiesis in adrenal gland. An uncommon cause of adrenal incidentaloma in sickle cell disease. Iranian journal of pediatrics. 24 (6): 784-6. Pubmed
- 6. Bastounis EA, Karayiannakis AJ, Anapliotou ML, Nakopoulou L, Makri GG, Papalambros EL. Incidentalomas of the adrenal gland: diagnostic and therapeutic implications. The American surgeon. 63 (4): 356-60. Pubmed