A 62-Year-Old Woman With Dyspnea, Leukocytosis, and Diffuse Ground-Glass Opacities

Bajwa, Abubakr; Usman, Faisal; Wolfson, David; Laos, Luis F.; Cury, James

doi:10.1378/chest.09-2602

Cited by 8 publications

(8 citation statements)

References 7 publications

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“…Ground glass appearance on CT chest as seen in our patient has been well described in case reports 5 6. Pulmonary hypertension as seen in our patient can result from a number of mechanisms, including pulmonary capillary obstruction, thrombotic events, interstitial pneumonitis and fibrosis, and alveolar airspace involvement, or from hematopoietic progenitor cell invasion of the pulmonary artery intima.…”

Section: Discussionsupporting

confidence: 78%

Pulmonary extramedullary haematopoiesis

et al. 2011

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Section: Discussionsupporting

confidence: 78%

Pulmonary extramedullary haematopoiesis

et al. 2011

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“…Ground-glass opacities per se are non-specific CT findings with more common differentials of congestive cardiac failure and lung infection in patients presenting with dyspnea. In the setting of myelofibrosis, additional possibilities include pulmonary extramedullary hematopoiesis, thromboembolism or chemotherapy-induced lung toxicity (7). In our case, the unique finding was the absence of any lung parenchymal abnormality on CT scan.…”

Section: Discussionmentioning

confidence: 99%

Extramedullary Pulmonary Hematopoiesis Causing Pulmonary Hypertension and Severe Tricuspid Regurgitation Detected by Technetium-99m Sulfur Colloid Bone Marrow Scan and Single-Photon Emission Computed Tomography/CT

et al. 2014

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Extramedullary pulmonary hematopoiesis is a rare entity with a limited number of case reports in the available literature only. We report the case of a 66-year-old man with known primary myelofibrosis, in whom a Technetium-99m sulfur colloid bone marrow scan with single-photon emission computed tomography (SPECT)/CT revealed a pulmonary hematopoiesis as the cause of pulmonary hypertension and severe tricuspid regurgitation. To the best of our knowledge, this is the first description of Technetium-99m sulfur colloid SPECT/CT imaging in this rare condition.

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“…Generally, the association between MPN and EMH is well established 18 . However, pulmonary EMH is uncommon and only a few cases have been reported 19–23 . Of these, Asakura et al .…”

Section: Discussionmentioning

confidence: 99%

“…18 However, pulmonary EMH is uncommon and only a few cases have been reported. [19][20][21][22][23] Of these, Asakura et al reported MPN patients with EMH and varying degrees of fibrosis in the lung. 23 It was previously established that fibrosis in the bone marrow stroma in MPN is a reactive process driven by platelet-derived cytokines released from clonal megakaryocytes.…”

Section: Discussionmentioning

confidence: 99%

Case of polycythemia vera with unusual organizing pneumonia mimicking the clinical features of military tuberculosis and possibly caused by the involvement of neoplastic megakaryocytes

Kimura¹,

Imamura²,

Higaki³

et al. 2011

Pathology International

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Polycythemia vera (PV) is a clonal myeloproliferative neoplasm (MPN) of hematopoietic stem cells. Although the management of MPN patients generally focuses on the prevention of thromboembolic events caused by hypercoagulability, it is true that the patients with hematological malignancy often suffer from pulmonary diseases with atypical radiological patterns. We present here a 56-year-old woman with PV harboring a JAK2(V617F) mutation that had a diffuse reticulonodular pattern on chest radiography and was initially suspected of having military tuberculosis. Pathological assessment of a video-assisted thoracoscopic surgery lung biopsy revealed that the lesions were in fact organizing pneumonia (OP). Interestingly, pulmonary extramedullary hematopoiesis with a diffuse plugging of the alveolar blood capillaries by numerous atypical megakaryocytes was also observed around the granulation components. The histological findings of our case of unusual OP suggest that local activated neoplastic megakaryocytes and platelets played an important role in the development of spreading fibrotic lesions. JAK2 mutation or the preleukemic phase of MPN may accelerate the activation of megakaryocytes and result in the proliferative process of fibrosis.

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A 62-Year-Old Woman With Dyspnea, Leukocytosis, and Diffuse Ground-Glass Opacities

Cited by 8 publications

References 7 publications

Pulmonary extramedullary haematopoiesis

Pulmonary extramedullary haematopoiesis

Extramedullary Pulmonary Hematopoiesis Causing Pulmonary Hypertension and Severe Tricuspid Regurgitation Detected by Technetium-99m Sulfur Colloid Bone Marrow Scan and Single-Photon Emission Computed Tomography/CT

Case of polycythemia vera with unusual organizing pneumonia mimicking the clinical features of military tuberculosis and possibly caused by the involvement of neoplastic megakaryocytes

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