Extramedullary haemopoiesis in a thalassemia major patient

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis certain


Known case of thalassemia major with left upper quadrant abdominal severe pain.

Patient Data

Age: 20 years.
Gender: Female

Marked hepatosplenomegaly and multiple gall bladder calculi are seen. US exam done before the patient underwent splenectomy.

known case of a thalassemia major patient underwent splenectomy and cholecystectomy. Noted postoperative changes in the splenic bed with thick left perirenal fascia. Evidence of little pelvic perivesical collection.

MRI of the same patient with evident of marrow trabecular changes.

Case Discussion

A known patient with thalassemia major post splenectomy and cholecystectomy with bilateral paraspinal masses likely extramedullary hematopoiesis. Extramedullary hematopoiesis affects organs, that are usually radiographic evidence of their enlargement, e.g. hepatomegaly, splenomegaly seen by ultrasound, CT or MRI. Lesions are typically hypermetabolic and hence is FDG-18 avid on PET-CT.1

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