Presentation
History of anaemia since the paediatric period, now presented with upper abdominal pain and dyspnoea
Patient Data
Contrast-enhanced thoracic CT shows multiple enhancing soft tissue masses in bilateral para-vertebral gutters in favour of extramedullary haematopoiesis.
Moderate pleural effusion and a chest tube with the passive collapse of the right lung base is evident in the right hemithorax. Amorphous dense material in the effusion in right hemithorax is in favour of haematoma.
Another soft tissue mass of extramedullary haematopoiesis is also seen in the pre-sacral area. Evidence of splenectomy and hepatomegaly is seen.
Few smaller than 2-centimetre hepatic nodules with delayed washout but without arterial hyper-enhancement are seen in the left liver lobe.
Red arrows point to pre-sacral and paravertebral extramedullary haematopoiesis. Blue arrow points to hepatic lesions.
Case Discussion
The patient has a history of beta-thalassaemia intermedia with multiple transfusions and a history of the previous splenectomy. He referred because of dyspnoea and abdominal pain. No specific cause for abdominal pain was found. The right-side pleural effusion drained by chest tube insertion.
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