Lung masses in a thalassemia patient: A diagnostic dilemma

Abstract

Thalassemia is a common congenital hemolytic anemia in the South Asian subcontinent. This disease is associated with multiple complications, which accumulate as the age of the patient progresses. Extramedullary hematopoiesis (EMH) is a compensatory physiological mechanism for chronic anemia. EMH can occur in different parts of the body and present with varied imaging features, some of which may be misleading. We here describe the case of a 22-year-old male patient with thalassemia who presented with paracardiac lobulated masses on chest X-ray. They were thought to be lung tumors; however, subsequent computed tomography scan of the thorax showed typical features of EMH involving the vertebrae, ribs and sternum. The patient was assured about the appearance of the masses on the chest X-ray. Imaging features of EMH in the thorax has been discussed in detail.