Thoracic extramedullary hematopoiesis

Case contributed by Dr Devpriyo Pal

Presentation

Known case of thalassemia, on regular blood transfusion.

Patient Data

Age: 25 years
Gender: Female

Multiple lobulated masses in bilateral para-vertebral region along with enlargement of anterior ends of ribs.

Case Discussion

Extramedullary hematopoiesis (EMH) is the process of proliferation of hematopoietic cells outside the medulla of the bones which contain marrow with hematopoietic stem cells. It usually happens in response to inadequate circulating erythrocytes which fail to satisfy the oxygen demand of the body.

The decreased production may be caused by several conditions like myelofibrosis or chronic myelogenous leukemia which lead to decreased production or chronic hemolytic anemia like thalassemia or sickle cell anemia where the destruction of cells are increased.

Intrathoracic EMH manifests most commonly as a paraosseous mass (which originates from within the bone) or interstitial pulmonary abnormality or even pleural masses.

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