Paravertebral Mass in a Patient With Thalassemia Intermedia

A 26‐yr-old female with persistent cough

“…EMH is due to the production of blood cells outside the bone marrow and is a compensatory mechanism for bone marrow dysfunction [2].…”

“…EMH develops as a reactive process in various chronic anaemias, especially thalassemia [1][2][3], sickle cell anaemia [4], and hereditary spherocytosis [5]. It is rarely seen in Gaucher9s disease [6], Paget9s disease [7], alcohol-related macrocytosis [8] and congenital dyserythyropoietic anaemia [9].…”

“…This erythroid response is most often microscopic but can result in organomegaly or the development of tumour-like masses usually involving the liver, spleen and lymph nodes. Less frequently involved sites include the kidney, adrenal glands, breasts, spinal cord, intrathoracic cavity, pleura, pericardium and intracranial cavity [2].…”

“…When the bone marrow dysfunction is obvious and intrathoracic EMH is suspected, the presence of the characteristic findings on a chest roentgenogram and chest CT scan should suffice to make the diagnosis [2]. These characteristic findings are: widening of the ribs, unilateral or bilateral wellcircumscribed lobulated paravertebral mass lesions usually located caudal to the sixth thoracic vertebrae, subpleural paracostal masses without bony erosion, absence of calcification, and the presence of adipose tissue within the mass [2,7,10].…”

“…These characteristic findings are: widening of the ribs, unilateral or bilateral wellcircumscribed lobulated paravertebral mass lesions usually located caudal to the sixth thoracic vertebrae, subpleural paracostal masses without bony erosion, absence of calcification, and the presence of adipose tissue within the mass [2,7,10].…”