Abdulla Al-Aabassi1, Basil A Murad. 1. Department of General Surgery, Saqr Hospital, Ras Alkhaimah, United Arab Emirates. albassi@hotmail.com
Abstract
OBJECTIVE: To report a rare case of extramedullary hematopoiesis (EMH) with an asymptomatic intrapelvic mass in a patient with thalassemia major. CLINICAL PRESENTATION: The patient presented with a pelvic mass discovered by ultrasonography before undertaking laparoscopic cholecystectomy for gallstones. Technetium-99m MDP bone scan failed to differentiate EMH from malignancy. A fine-needle aspiration smear was misdiagnosed when atypical megakaryocytes were interpreted as malignant cells. EMH was suggested by magnetic resonance imaging and confirmed by an ultrasound-guided Tru-Cut biopsy. CONCLUSION: This case report illustrates the need to consider EMH in the differential diagnosis of patients with chronic hematological disorders and mass lesions in extramedullary sites.
OBJECTIVE: To report a rare case of extramedullary hematopoiesis (EMH) with an asymptomatic intrapelvic mass in a patient with thalassemia major. CLINICAL PRESENTATION: The patient presented with a pelvic mass discovered by ultrasonography before undertaking laparoscopic cholecystectomy for gallstones. Technetium-99m MDP bone scan failed to differentiate EMH from malignancy. A fine-needle aspiration smear was misdiagnosed when atypical megakaryocytes were interpreted as malignant cells. EMH was suggested by magnetic resonance imaging and confirmed by an ultrasound-guided Tru-Cut biopsy. CONCLUSION: This case report illustrates the need to consider EMH in the differential diagnosis of patients with chronic hematological disorders and mass lesions in extramedullary sites.
Authors: Andrew W Ginzel; Mark J Kransdorf; Jeffrey J Peterson; Hillary W Garner; Mark D Murphey Journal: Skeletal Radiol Date: 2011-11-20 Impact factor: 2.199