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Extramedullary hemopoiesis with undiagnosed, early myelofibrosis causing spastic compressive myelopathy: Case report and review.

Dewan U, Kumari N, Jaiswal A, Behari S, Jain M - Indian J Orthop (2010)

Bottom Line: A 62-year-old man presented with paraparesis.The patient had no known cause for EMH at the time of diagnosis but, subsequently, a bone marrow examination revealed early myelofibrosis.This case represents the rare occurrence of a large extradural extramedullary hematopoiesis in a patient with no known predisposing factor for hemopoiesis at the time of presentation.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

ABSTRACT
Extramedullary hemopoiesis (EMH) is a common compensatory phenomenon associated with chronic hemolytic anemia. Abnormal hemopoietic tissue usually develops in sites responsible for fetal hemopoiesis, such as spleen, liver and kidney; however, other regions such as the spine may also become involved. In this study, a patient presenting with spastic paraparesis due to EMH in the dorsal spine is described. A 62-year-old man presented with paraparesis. Magnetic resonance imaging revealed a large lesion involving the T2-L2 vertebral levels with a large extradural component causing thecal sac compression. Laminectomy with excision of mass was carried out. The histopathology revealed EMH. The patient had no known cause for EMH at the time of diagnosis but, subsequently, a bone marrow examination revealed early myelofibrosis. This case represents the rare occurrence of a large extradural extramedullary hematopoiesis in a patient with no known predisposing factor for hemopoiesis at the time of presentation.

No MeSH data available.


Related in: MedlinePlus

(a) Myeloid cells (arrow) admixed with erythroid cells and megakaryocytes (H and E, ×40). (b) Increased reticulin (arrow) on bone marrow biopsy (Retic ×40)
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Figure 0002: (a) Myeloid cells (arrow) admixed with erythroid cells and megakaryocytes (H and E, ×40). (b) Increased reticulin (arrow) on bone marrow biopsy (Retic ×40)

Mentions: The histopathology of the lesion showed a vaguely nodular collection of hematopoietic cells comprising of various stages of erythroid cells, myeloid cells and megakaryocytes with an intertraversing sinusoidal capillary network [Figure 2a]. A histolological confirmation was obtained by staining these sections with periodic acid Schiff stain for megakaryocytes and chloroacetate esterase for myeloid cells, respectively. The megakaryocytes showed magenta-colored cytoplasmic positivity with periodic acid Schiff stain and the myeloid cells showed brownish, granular cytoplasmic positivity with chloroacetate staining.


Extramedullary hemopoiesis with undiagnosed, early myelofibrosis causing spastic compressive myelopathy: Case report and review.

Dewan U, Kumari N, Jaiswal A, Behari S, Jain M - Indian J Orthop (2010)

(a) Myeloid cells (arrow) admixed with erythroid cells and megakaryocytes (H and E, ×40). (b) Increased reticulin (arrow) on bone marrow biopsy (Retic ×40)
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2822429&req=5

Figure 0002: (a) Myeloid cells (arrow) admixed with erythroid cells and megakaryocytes (H and E, ×40). (b) Increased reticulin (arrow) on bone marrow biopsy (Retic ×40)
Mentions: The histopathology of the lesion showed a vaguely nodular collection of hematopoietic cells comprising of various stages of erythroid cells, myeloid cells and megakaryocytes with an intertraversing sinusoidal capillary network [Figure 2a]. A histolological confirmation was obtained by staining these sections with periodic acid Schiff stain for megakaryocytes and chloroacetate esterase for myeloid cells, respectively. The megakaryocytes showed magenta-colored cytoplasmic positivity with periodic acid Schiff stain and the myeloid cells showed brownish, granular cytoplasmic positivity with chloroacetate staining.

Bottom Line: A 62-year-old man presented with paraparesis.The patient had no known cause for EMH at the time of diagnosis but, subsequently, a bone marrow examination revealed early myelofibrosis.This case represents the rare occurrence of a large extradural extramedullary hematopoiesis in a patient with no known predisposing factor for hemopoiesis at the time of presentation.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.

ABSTRACT
Extramedullary hemopoiesis (EMH) is a common compensatory phenomenon associated with chronic hemolytic anemia. Abnormal hemopoietic tissue usually develops in sites responsible for fetal hemopoiesis, such as spleen, liver and kidney; however, other regions such as the spine may also become involved. In this study, a patient presenting with spastic paraparesis due to EMH in the dorsal spine is described. A 62-year-old man presented with paraparesis. Magnetic resonance imaging revealed a large lesion involving the T2-L2 vertebral levels with a large extradural component causing thecal sac compression. Laminectomy with excision of mass was carried out. The histopathology revealed EMH. The patient had no known cause for EMH at the time of diagnosis but, subsequently, a bone marrow examination revealed early myelofibrosis. This case represents the rare occurrence of a large extradural extramedullary hematopoiesis in a patient with no known predisposing factor for hemopoiesis at the time of presentation.

No MeSH data available.


Related in: MedlinePlus