Secondary hemochromatosis


Following repeated blood transfusions, this patient developed secondary iron overload or secondary hemochromatosis, with the cells of the reticuloendothelial system (RES) being the main reservoir.

In the case of secondary hemochromatosis, iron will be building up in both RES and non-RES tissues, which sometimes helps differentiate both forms radiologically.

The bony changes in this patient are thought to be the effect of chronic severe anemia, and the presacral soft tissue is best explained by extramedullary hematopoiesis.

This case would be a classic for a fellowship viva or long case, such as in the FRCR 2b exam.