Presentation
Beta thalassaemia patient with a fever. Collection?
Patient Data
Age: 20 years
Gender: Female
From the case:
Beta thalassaemia
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CT chest
- small paravertebral soft tissue abnormalities in keeping with extramedullary haematopoiesis
- 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 thalassaemia patient.
Features evident:
- extramedullary haematopoiesis (typical paravertebral location)
- hyperattenuating liver from repeat blood transfusions given secondary haemochromatosis
- gallstones
- hepatosplenomegaly (or splenectomy or infarcted spleen in other cases)
- coarse appearance to the bones
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