PET CT imaging in extramedullary hematopoiesis and lung cancer surprise in a case with thalassemia intermedia

Abstract

Extramedullary hematopoiesis (EMH) is the production of hematopoietic precursors outside the bone marrow cavity, and it causes mass effects according to its localization. Magnetic resonance imaging (MRI) and/or computed tomography (CT) scans are used most commonly to detect EMH foci. We report herein a case with thalassemia intermedia causing paravertebral mass associated with EMH detected by CT scan. We further evaluated the case with positron emission tomography (PET) CT, and lung cancer, which was not revealed in the CT scan, was detected coincidentally. (Turk J Hematol 2011; 28: 60-2) Key words: Extramedullary hematopoiesis, PET CT, SUV max ÖzetEkstramedüller hematopoez (EMH), hematopoetik öncü hücrelerin kemik iliği dışında üretimidir ve lokalizasyonuna göre kitle etkilerine neden olur. EMH odaklarını saptamada en sık MRI ve/veya CT kullanılır. Biz burada talasemi intermedia'lı bir olguda paravertebral kitleye yol açan ve CT ile saptanan bir EMH olgusu sunduk. PET CT ile daha ileri incelemede, CT ile saptanamamış olan, akciğer kanseri saptandı. (Turk J Hematol 2011; 28: 60-2)

Extramedullary Hematopoiesis Visualized on FDG-PET/CT in a Patient with Beta-Thalassemia

“…As a result of the findings in the spleen on FDG-PET/CT, the patient underwent uncomplicated splenectomy and was discharged from hospital after 14 days in stable condition. Here the patient achieved double benefit of the splenectomy in treating the infection and potentially reducing future transfusion requirements [1][2][3][4]. Our findings mirror the typical characteristics described in the literature of EMH, and in this case, FDG-PET/CT contributed to the finding of the focus of infection in a male known with beta-thalassemia media [5][6][7][8][9][10][11] (Fig.…”

Mass-Forming Extramedullary Hematopoiesis in Multiple Myeloma: 18F-FDG PET/CT is useful in Excluding Extramedullary Myeloma Involvement

“…The characteristics of EMH on 18 F-FDG PET/CT have not yet been established, with only 2 cases reported to date (8, 9). There is currently no report regarding 18 F-FDG PET/CT scans of EMH mimicking malignancy in MM.…”

“…There is currently no report regarding 18 F-FDG PET/CT scans of EMH mimicking malignancy in MM. In one report describ- ing thoracic EMH diagnosed upon 18 F-FDG PET/CT in a thalassemia patient, the authors found a 13-cm paravertebral mass at the posterior-inferior mediastinum with mild FDG avidity (SUV max = 2.5) (8). Another report of a thalassemia patient revealed multiple paravertebral thoracic masses with mild to moderate FDG avidity (SUV max not indicated) (9).…”

Intrathoracic extramedullary hematopoiesis as a posterior mediastinal tumor: a case report

“…Magnetic resonance imaging (MRI) and thorax computed tomography (CT) scans are the most commonly used diagnostic method for EMH. They appear as lobular masses in the paravertebral region [4]. In diagnosis, PET/CT scan may be useful.…”