Adrenal extramedullary hematopoiesis, an entity to consider in the diagnosis of adrenal mass

Abstract

Extramedullary Hematopoiesis (EMH) is frequently seen in the liver, spleen or lymph nodes in patients with hematologic disorders such as beta-thallasemia or hereditary spherocytosis. We report the fi rst case of adrenal hematopoiesis in a patient with Chronic Myelomonocytic Leukemia. The patient was a 63 year-old man who was in the study of a thrombocytopenia. A CT and MRI demonstrated a unilateral adrenal mass with multiple splenic lesions. The patient underwent right adrenalectomy and splenectomy. Microscopic examination showed extramedullary hematopoiesis in the adrenal gland and spleen. The diagnosis of extramedullary hematopoiesis must be considered in any patient with hematologic disorders and thoracic or abdominal mass. An unnecessary procedure could be avoided.