Beta thalassemia

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Beta thalassemia patient with a fever. Collection?

Patient Data

Age: 20 years
Gender: Female
ct
This study is a stack
Axial C+
arterial phase
This study is a stack
Axial C+ portal
venous phase
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Info

CT chest

  • small paravertebral soft tissue abnormalities in keeping with extramedullary hematopoiesis
  • lungs clear

CT abdomen

  • hepatomegaly. The liver is diffusely hyperdense
  • multiple tiny low attenuation foci in the liver, likely to represent small abscesses
  • moderate splenomegaly
  • multiple enlarged lymph nodes/necrotic lymph nodes in the upper abdomen, the para-aortic space, small bowel mesentery and left anterior abdomen
  • mild free ascites
  • small gallstones
  • coarse texture to the bony skeleton

Case Discussion

Fellowship exam long or viva case example of a thalassemia patient.

Features evident:

  • extramedullary hematopoiesis (typical paravertebral location)
  • hyperattenuating liver from repeat blood transfusions given secondary hemochromatosis
  • gallstones
  • hepatosplenomegaly (or splenectomy or infarcted spleen in other cases)
  • coarse appearance to the bones

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