Diagnosis of spinal extramedullary hemopoiesis by magnetic resonance imaging

Ma, Shariia; Chan, Jane; Wong, K.F.

doi:10.1016/0002-9343(93)90239-l

Cited by 6 publications

(4 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Diagnosis can be confirmed via a needle biopsy guided by CT [18]. MRI is the best method for demonstrating spinal cord compression and is an alternative to CT. MRI also appears to be ideal for delineating the extent of the intraspinal masses and visualizes the entire spine [5, 6, 9]; it is thus the modality of choice for the diagnosis and follow-up of these patients [12,17]. On T1-weighted images, EMH appears as extramedullary masses of signal intensity slightly higher than that of the adjacent bone marrow of the vertebral bodies [9].…”

Section: Discussionmentioning

confidence: 99%

“…Obtaining a histopathological definitive diagnosis is another advantage of surgical treatment. The disadvantages of surgical therapy include risk of general anesthesia, cardiovascular instability due to anemia, iron overload, and difficulty in total excision due to the diffuse nature of the process [9,12,14,15]. Spinal instability and the risk of reoperation due to rapid recurrence are important postoperative complications.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Spinal cord compression secondary to extramedullary hematopoiesis in thalassemia intermedia

Çoşkun

Keskïn

Süzer

et al. 1998

European Spine Journal

View full text Add to dashboard Cite

Extramedullary hematopoiesis associated with thalassemia causing spinal cord compression is an extremely rare event in the course of the disease. Documentation with an imaging technique, such as MRI, is mandatory. A patient with thalassemia intermedia, who developed paraparesis in spite of transfusion, underwent surgical decompression. Rapid neurological improvement was observed postoperatively and this neurological condition was protected with adequate hemoglobin level. Management of these patients remains controversial. Various modes of therapy such as surgical decompression, radiotherapy, and transfusion are discussed and the related literature is reviewed.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Spinal cord compression secondary to extramedullary hematopoiesis in thalassemia intermedia

Çoşkun

Keskïn

Süzer

et al. 1998

European Spine Journal

View full text Add to dashboard Cite

show abstract

“…Differentiation from epidural lymphoma can be facilitated by a history of a hematological condition. [ 2 9 16 18 ] In the absence of availability or contraindication to the use of an MRI, a computed tomography (CT) scan can be used. A tissue diagnosis can be obtained via CT-guided needle biopsy which carries a significant risk for hemorrhage and neurological deterioration especially in cases where they are epidural in location.…”

Section: Discussionmentioning

confidence: 99%

Thalassemia, extramedullary hematopoiesis, and spinal cord compression: A case report

2016

View full text Add to dashboard Cite

Background:Extramedullary hematopoiesis (EMH) refers to hematopoiesis outside of the medulla of the bone. Chronic anemia states such as thalassemia can cause hematopoietic tissue to expand in certain locations. We report a case of spinal cord compression due to recurrent spinal epidural EMH, which was treated with a combination of surgery and radiotherapy. Pakistan has one of the highest incidence and prevalence of thalassemia in the world. We describe published literature on diagnosis and management of such cases.Case Description:An 18-year-old male presented with bilateral lower limb paresis. He was a known case of homozygous beta thalassemia major. He had undergone surgery for spinal cord compression due to EMH 4 months prior to presentation. Symptom resolution was followed by deterioration 5 days later. He was operated again at our hospital with complete resection of the mass. He underwent local radiotherapy to prevent recurrence. At 2 years follow-up, he showed complete resolution of symptoms. Follow-up imaging demonstrated no residual mass.Conclusion:The possibility of EMH should be considered in every patient with ineffective erythropoiesis as a cause of spinal cord compression. Treatment of such cases is usually done with blood transfusions, which can reduce the hematopoietic drive for EMH. Other options include surgery, hydroxyurea, radiotherapy, or a combination of these on a case to case basis.

show abstract

“…However, it is invasive and requires contrast administration. MRI, now the recommended test of choice 12 , is able to visualize cord compression and paraspinal masses without contrast administration. On T1 or T2 weighted spin echo, extramedullary hematopoiesis appears as a higher signal intensity compared to adjacent marrow of the vertebral bodies 13 .…”

mentioning

confidence: 99%