Sickle cell anemia: forme fruste

Case contributed by Dr Ian Bickle

Presentation

Febrile. Known sickle cell anaemia patient with multiple admissions. Confirm possible liver abscesses.

Patient Data

Age: 25 years
Gender: Female

Hepatosplenomegaly.

The liver and spleen are hyperdense in keeping with iron deposition.

Multiple lesions of varying size up to 2cm in the liver are consistent with abscesses.  Cystic lesions in the spleen are consistent with microabscesses.

Multiple calcified upper abdominal lymph nodes.

Free fluid in the pelvis.

Coarse appearances of the bony skeleton.

Small paravertebral soft tissue masses in keeping with extramedullary hematopoiesis.

Hepatosplenomegaly.

The liver and spleen are T1 and T2 hypointense in keeping with iron deposition.

Various T2 lesions of varying size in the liver consistent with abscesses.  Cystic lesion in the spleen.

Multiple upper abdominal lymph nodes, with low T1 and T2 signal.

Case Discussion

This case has the typical appearances of an adult sickle cell anemia patient.

In this case, the iron deposition in the liver and spleen is well illustrated on MRI with a profoundly low T1 and T2 signal appearance in both organs.

This patient group are susceptible to repeated infections and are regular hospital attendees.

The overall appearances are the forme fruste of sickle cell anemia and a reason this kind of scenario is popular in the examination setting. 

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Case information

rID: 59190
Published: 29th Mar 2018
Last edited: 29th Mar 2018
Tag: ripas2
Inclusion in quiz mode: Included

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