A 74-year-old man was diagnosed with unexplained normocytic/normochromic hemolytic anemia with negative indirect/direct Coombs tests and without any morphological changes at 67 years of age. At that time, computed tomography (CT) revealed bilateral masses in the lower thoracic paravertebral regions (Picture 1A). At 74 years of age, he had exertional dyspnea and CT revealed the increased size of the mass (Picture 1B). Indium-111-chloride-transferrin scintigraphy demonstrated the uptake of these masses (Picture 2). We performed a needle biopsy of the mass on the right side using video-assisted thoracoscopy without any complications (Picture 3). The biopsy specimen revealed hematopoietic cells composed of megakaryocytes, erythroblasts, and myeloid cells (Picture 4). Finally, he was diagnosed with extramedullary hematopoiesis (EMH).
Picture 1.
Picture 2.
Picture 3.
Picture 4.
EMH may sometimes manifest as a tumor-like mass, as occurred in our case (1). In this situation, we should carefully perform a biopsy, which is associated with a risk of catastrophic hemorrhage, to exclude malignant diseases (2).
The authors state that they have no Conflict of Interest (COI).
References
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