Presentation
Regular hospital attender. Peripheral clinic reported paravertebral mass on chest x-ray.
Patient Data
Age: 20 years
Gender: Male
From the case:
Extramedullary hematopoiesis
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Chest x-ray performed elsewhere not available - scanogram from CT in lieu of CXR.
Bilateral paravertebral mass.
Dense skeleton.
From the case:
Extramedullary hematopoiesis
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arterial phase"}],"caption":{"us":null,"gb":null},"findings":{"us":"","gb":""},"contributor_login":"clonvara","case_id":36625,"case_key_image_id":12537465,"case_featured_at":"21 May 2015"},"current_user":null,"access":{"can_edit":false,"can_download":true,"can_feature":false,"can_pin":true}}
Large paravertebral soft tissue masses (not lymph nodes). Appearance of 'ping-pong' balls.
Coarse sclerosis of the bony skeleton (secondary changes of thalassemia).
Splenectomy (removed due to repeated infarcts).
High attenuation liver - due to multiple blood transfusions.
From the case:
Extramedullary hematopoiesis
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Black arrow: paravertebral masses.
Red arrows: extramedullary hematopoiesis.
Green arrow: splenectomy.
Blue arrows: bony sclerosis.
Case Discussion
Classical appearances of extra-medullary hematopoiesis with the ancillary signs supporting a patient with sickle cell anemia, one the of main patient groups who present with this condition.
- large paravertebral soft tissue masses (not lymph nodes)
- coarse sclerosis of the bony skeleton (secondary changes of thalassemia)
- splenectomy (removed due to repeated infarcts)
- high attenuation liver - due to multiple blood transfusions
It makes for a fantastic FRCR 2B long case or viva case for discussion.