Table 2.
Focal intra-hepatic extra-medullary hematopoiesis: review of the literature.
| Iron Overload |
T1 WI | T2 WI | Gd-chelate | Additional Reports |
Histopathological Findings | Other Location |
Underlying Condition | |
|---|---|---|---|---|---|---|---|---|
| Kumar 1995 [49] | Yes | Isointense to L, hypointense to M | Isointense to L, hypointense to M | N/A | On proton density WI isointense to L, central necrotic areas | N/A | Para-vertebral | β-Thalassemia |
| Wong 1999 [48] | Yes | Hyperintense to L, isointense to M | Hyperintense to L, isointense to M | Heterogeneous enhancement (maximal at 2 min) |
Stellate scars within intra-hepatic EMH lesion (T1 hypointense, T2 hyperintense, delayed enhancement (5 min)) |
Hepatocytes, megakaryocytes, erythroid cell precursors, fibrous cells |
No | β-Thalassemia |
| Jelali 2006 [46] | Yes | Hyperintense to L, isointense to M | Slightly hyperintense to L, isointense to M | Absent in arterial phase and moderate in later phases | N/A | Periportal fibrosis and sinusoid dilatation with megakaryocytes | Para-aortic and para-spinal | Sickle cell disease |
| Belay 2018 [50] | Yes | Hypointense to L | Isointense to L | Heterogeneous mild arterial phase enhancement with washout to isointensity on portal venous and delayed phase | Isointense to L on DWI and T2* GRE | EMH with hepatocytes and Kupffer cells iron overload | Within right main pulmonary artery | Myelodysplastic syndrome |
| Warshauer 1991 [53] | No | Isointense to L and M | Hyperintense to L and M | Heterogeneous enhancement | N/A | N/A | No | Unknown |
| Tamm 1995 [54] | No | Hypointense to L | Hyperintense to L | No enhancement on dynamic injection, delayed enhancement | On spin-density images isointense to L | EMH, enlarged Kupffer cells with “tissue paper” cytoplasm (Gaucher disease) | No | Gaucher disease |
| Lee 2008 [47] | No | Hypointense to L and M | Hyperintense to L and M | Homogeneous intense arterial phase enhancement persistent to delayed phases (5 min) | Hyperintense on SPIO-enhanced T2*WI | Megakaryocytes, erythroid and myeloid precursors, histiocytic cells (CD68 IHC weaker than normal). No Kupffer cells | No | Essential thrombocythemia transformed into idiopathic myelofibrosis |
L = liver; M = spinal muscle; ICH = Immunohistochemistry; SPIO = Superparamagnetic Iron Oxide. N/A = not assessed.