Extra-medullary hematopoiesis of the liver in a patient with Thalassemia major
Iran University of Medical Sciences, Iran
: J Clin Exp Oncol
Extra-medullary hematopoiesis (EMH) refers to hematopoiesis occurring outside of the bone marrow. It can be physiologic or pathologic. The physiologic one occurs during embryonic and fetal development mainly. It has been done in many different locations, depending on the moment or the kind of hematopoiesis that is needed at that moment. Common sites of EMH include the mediastinum, spleen, and lymph nodes. The pathologic EMH can occur during adulthood when physiologic hematopoiesis can´t work properly in the bone marrow and the hematopoietic stem cells (HSC) have to migrate to other tissues in order to continue with the formation of blood cellular components. Thalassemia and its resultant hemolytic anemia is an important cause of pathologic EMH. We present a case of an extramedullary hematopoiesis (EMH) that mimicked a hepatic neoplasm in a 35-year-old man with thalassemia major. He presented with anemia and abdominal pain. Abdominal ultrasonography showed an echogenic solid mass in the right liver lobe. Abdominal CT scan and dynamic hepatic MRI demonstrated hepatocellular carcinoma (HCC). A core needle biopsy was performed under ultrasound guidance and histologic examination led to the diagnosis of extramedullary hematopoiesis (EMH) with no evidence of a malignant neoplasm.
Moosa Tahmouresi has completed his MD at the age of 26 years from Islamic Azad University and attended to residency program of Radiology at Iran University of Medical Sciences School of Medicine. He has worked at Tahmores imaging clinic, Kerman, Iran for 7 years.
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