Extramedullary hematopoiesis

Case contributed by Khaloud Alghamdi

Presentation

Known history of β-thalassemia major. A peripheral clinic reported a paravertebral mass on chest x-ray.

Patient Data

Age: 45 years
Gender: Male
X-ray

Bilateral posterior mediastinal paravertebral soft tissue masses.

MRI
  • Several paravertebral and pre/intercostal masses. The largest mass lies in the right paravertebral aspect at the levels of T7 to T10.

  • Overall, these masses have inhomogeneous low T1 and mixed T2 signal.

  • Inferior to the larger masses, below the T10 level, there is some increased paravertebral fat on both sides, more on the left side, non-specific.

  • Overall, low T1 signal of the bone marrow, consistent with marrow reconversion.

  • No bony abnormalities, no disc herniations, no central canal stenosis. No abnormalities of the spinal cord.

  • Splenomegaly. The inferior margin is not imaged.

Case Discussion

Classical appearances of extra-medullary hematopoiesis,in a patient with β-thalassemia major anemia.

  • Large paravertebral and intercostal soft tissue masses.
  • Low T1 bone marrow signal indicating bone conversion.
  • Splenomegaly.

The case was contributed by Dr Raquel Del Carpio-O'donovan, Professor of Radiology, Neurology, Neurosurgery at McGill University.

    How to use cases

    You can use Radiopaedia cases in a variety of ways to help you learn and teach.

    Creating your own cases is easy.

    Updating… Please wait.

     Unable to process the form. Check for errors and try again.

     Thank you for updating your details.