Mass-like extramedullary hematopoiesis: imaging features

Abstract

Mass-like extramedullary hematopoiesis most commonly presents as multiple, fat-containing lesions localized to the axial skeleton. When these imaging features are identified, extramedullary hematopoiesis should be strongly considered, particularly when occurring in the setting of a predisposing medical condition.

Imaging the posterior mediastinum: a multimodality approach

“…Long-standing anemia or extensive bone marrow replacement by myeloproliferative disorders elicit the expansion of hematopoietic tissue outside of the bone marrow and may lead to the development of masslike lesions, most often in the paravertebral thoracic region (18).…”

“…Malignant esophageal tumors usually produce intermediate signal intensity on T2-weighted images, unless they contain a high amount of extracellular mucin, which characteristically turns them hyperintense on these sequences (45). 18 F-FDG-PET scanning is recommended to improve the accuracy of staging of distant disease in patients who are potential candidates for curative therapy, whereas the value of 18 F-FDG-PET as a predictive marker of response to neoadjuvant therapy remains uncertain (Fig. 8) (49, 50).…”

“…Medical therapy should be integrated with surgical or CT-guided percutaneous catheter drainage of any paraspinal abscess (17). Treatment response to antibiotics can be evaluated by either CT, MRI, or 18 F-FDG-PET/CT.…”

“…Nuclear medicine imaging and CT-guided biopsy are reserved for atypical cases, such as in patients with a single lesion in the paravertebral area (18).…”

“…18 F-fluorodeoxyglucose positron emission tomography ( 18 F-FDG-PET) scanning has reasonable accuracy (82%) in distinguishing malignant forms from benign forms.…”