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.

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    Case information

    rID: 78893
    Published: 14th Jun 2020
    Last edited: 16th Jun 2020
    Inclusion in quiz mode: Included
    Institution: McGill University

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