Name : Sharam
Affiliation : Assistant professor of radiology,Masih Hospital,SBMU
Academic Degree: ----------------
Resident : Leila Sourtij
Gender : Male
Age : 23
A 23 years old man with sever anemia and extrameduullary hematopoesis
Imaging Procedures and Findings
Chest CT scan with IV contrast demonstrates osteolysis in ribs and vertebrea, rib expansion, soft tissue masses in paravertebral area and adjacent to ribs. morever cardiomegaly and bilateral pleural effusion are noted.
Extramedullary hematopoiesis is a compensatory phenom- enon that occurs when erythroc''te production is diminished or destruction is accelerated. Extramedullary hematopoiesis is usually seen in patients with chronic hemolltic disorders such as thalassemia, hereditary sphe- rocltosis, sickle cell disease, or ortensive bone marrow replacement owing to myelofibrosis. Extramedullary hema- topoiesis is usually microscopic and commonly involves the liver, spleen, and lymph nodes. Thoracic manifesta- tions are less common and consist of paravertebral soft tissue masses. The masses represent extrusion of the marrow through the thinned cortex of the posterior ribs. Histologi- cally, the masses resemble splenic tissue with hematopoi- etic elements mixed with fat. The masses are usually bilateral, contain no calcification, and cause no rib destruc-tion. Additional masses can be found along the lateral margins of the ribs. On CT, extramedullary hematopoiesis manifests as a heterogeneous mass or masses, often with focal areas of fat within the lesion . The typical MRI appearance consists of well-marginated, smooth or Iobulated, unilateral or bilateral paravertebral masses. T1- and T2-weighted MR images typically show bilateral heterogeneous masses with increased signal intensity on T1-weighted images because of fat within the masses.
CT and MR imaging of the whole body / [edited by] John R. Haaga ... jet al.].-5th ed