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Extramedullary Hematopoiesis, Spine
Lubdha M. Shah, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Extramedullary hematopoiesis (EMH)
              • Definitions

                • Epidural ± paravertebral proliferation of hematopoietic tissue in response to profound chronic anemia

              IMAGING

              • General Features

                • Radiographic Findings

                  • CT Findings

                    • MR Findings

                      • Nonvascular Interventions

                        • Nuclear Medicine Findings

                          • Imaging Recommendations

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Mattei TA et al: Ectopic extramedullary hematopoiesis: evaluation and treatment of a rare and benign paraspinal/epidural tumor. J Neurosurg Spine. 18(3):236-42, 2013
                                              2. Işık Balcı Y et al: Presacral and intrathoracic extramedullary hematopoiesis: a case report. Clin Imaging. 36(4):406-8, 2012
                                              3. Monti L et al: Myelodysplasia presenting as thoracic spinal epidural extramedullary hematopoiesis: a rare treatable cause of spinal cord myelopathy. Skeletal Radiol. 41(5):611-4, 2012
                                              4. Zhu G et al: Clinical and imaging findings in thalassemia patients with extramedullary hematopoiesis. Clin Imaging. 36(5):475-82, 2012
                                              5. Das D et al: MRI appearances of extramedullary haematopoiesis presenting with cauda equina syndrome in sickle cell disease. Clin Radiol. 66(12):1219-22, 2011
                                              6. Haidar R et al: Paraspinal extramedullary hematopoiesis in patients with thalassemia intermedia. Eur Spine J. 19(6):871-8, 2010
                                              7. Varlet G et al: [Beta-thalassemia intermedia complicated by spinal cord compression. Report of three cases and meta-analysis.] Neurochirurgie. 56(4):315-23, 2010
                                              8. Singh S et al: Paraspinal extramedullary hematopoiesis diagnosed using Tc-99m sulfur colloid. Clin Nucl Med. 33(11):794-6, 2008
                                              9. Salehi SA et al: Spinal cord compression in beta-thalassemia: case report and review of the literature. Spinal Cord. 42(2):117-23, 2004
                                              10. Koch CA et al: Nonhepatosplenic extramedullary hematopoiesis: associated diseases, pathology, clinical course, and treatment. Mayo Clin Proc. 78(10):1223-33, 2003
                                              11. Cario H et al: Treatment with hydroxyurea in thalassemia intermedia with paravertebral pseudotumors of extramedullary hematopoiesis. Ann Hematol. 81(8):478-82, 2002
                                              12. Alorainy IA et al: MRI features of epidural extramedullary hematopoiesis. Eur J Radiol. 35(1):8-11, 2000
                                              13. Aydingoz U et al: Spinal cord compression due to epidural extramedullary haematopoiesis in thalassaemia: MRI. Neuroradiology. 39(12):870-2, 1997
                                              14. Dibbern DA Jr et al: MR of thoracic cord compression caused by epidural extramedullary hematopoiesis in myelodysplastic syndrome. AJNR Am J Neuroradiol. 18(2):363-6, 1997
                                              15. Guermazi A et al: Imaging of spinal cord compression due to thoracic extramedullary haematopoiesis in myelofibrosis. Neuroradiology. 39(10):733-6, 1997
                                              16. Kalina P et al: Cord compression by extramedullary hematopoiesis in polycythemia vera. AJR Am J Roentgenol. 164(4):1027-8, 1995
                                              17. Papavasiliou C: Clinical expressions of the expansion of the bone marrow in the chronic anemias: the role of radiotherapy. Int J Radiat Oncol Biol Phys. 28(3):605-12, 1994
                                              18. Kalina P et al: MR of extramedullary hematopoiesis causing cord compression in beta-thalassemia. AJNR Am J Neuroradiol. 13(5):1407-9, 1992
                                              19. Konstantopoulos K et al: A case of spinal cord compression by extramedullary haemopoiesis in a thalassaemic patient: a putative role for hydroxyurea? Haematologica. 77(4):352-4, 1992
                                              20. Gouliamos A et al: Low back pain due to extramedullary hemopoiesis. Neuroradiology. 33(3):284-5, 1991
                                              21. Kaufmann T et al: The role of radiation therapy in the management of hematopoietic neurologic complications in thalassemia. Acta Haematol. 85(3):156-9, 1991
                                              22. Papavasiliou C et al: Masses of myeloadipose tissue: radiological and clinical considerations. Int J Radiat Oncol Biol Phys. 19(4):985-93, 1990
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        • Diagnostic Checklist

                                                          TERMINOLOGY

                                                          • Abbreviations

                                                            • Extramedullary hematopoiesis (EMH)
                                                          • Definitions

                                                            • Epidural ± paravertebral proliferation of hematopoietic tissue in response to profound chronic anemia

                                                          IMAGING

                                                          • General Features

                                                            • Radiographic Findings

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Nonvascular Interventions

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Mattei TA et al: Ectopic extramedullary hematopoiesis: evaluation and treatment of a rare and benign paraspinal/epidural tumor. J Neurosurg Spine. 18(3):236-42, 2013
                                                                                          2. Işık Balcı Y et al: Presacral and intrathoracic extramedullary hematopoiesis: a case report. Clin Imaging. 36(4):406-8, 2012
                                                                                          3. Monti L et al: Myelodysplasia presenting as thoracic spinal epidural extramedullary hematopoiesis: a rare treatable cause of spinal cord myelopathy. Skeletal Radiol. 41(5):611-4, 2012
                                                                                          4. Zhu G et al: Clinical and imaging findings in thalassemia patients with extramedullary hematopoiesis. Clin Imaging. 36(5):475-82, 2012
                                                                                          5. Das D et al: MRI appearances of extramedullary haematopoiesis presenting with cauda equina syndrome in sickle cell disease. Clin Radiol. 66(12):1219-22, 2011
                                                                                          6. Haidar R et al: Paraspinal extramedullary hematopoiesis in patients with thalassemia intermedia. Eur Spine J. 19(6):871-8, 2010
                                                                                          7. Varlet G et al: [Beta-thalassemia intermedia complicated by spinal cord compression. Report of three cases and meta-analysis.] Neurochirurgie. 56(4):315-23, 2010
                                                                                          8. Singh S et al: Paraspinal extramedullary hematopoiesis diagnosed using Tc-99m sulfur colloid. Clin Nucl Med. 33(11):794-6, 2008
                                                                                          9. Salehi SA et al: Spinal cord compression in beta-thalassemia: case report and review of the literature. Spinal Cord. 42(2):117-23, 2004
                                                                                          10. Koch CA et al: Nonhepatosplenic extramedullary hematopoiesis: associated diseases, pathology, clinical course, and treatment. Mayo Clin Proc. 78(10):1223-33, 2003
                                                                                          11. Cario H et al: Treatment with hydroxyurea in thalassemia intermedia with paravertebral pseudotumors of extramedullary hematopoiesis. Ann Hematol. 81(8):478-82, 2002
                                                                                          12. Alorainy IA et al: MRI features of epidural extramedullary hematopoiesis. Eur J Radiol. 35(1):8-11, 2000
                                                                                          13. Aydingoz U et al: Spinal cord compression due to epidural extramedullary haematopoiesis in thalassaemia: MRI. Neuroradiology. 39(12):870-2, 1997
                                                                                          14. Dibbern DA Jr et al: MR of thoracic cord compression caused by epidural extramedullary hematopoiesis in myelodysplastic syndrome. AJNR Am J Neuroradiol. 18(2):363-6, 1997
                                                                                          15. Guermazi A et al: Imaging of spinal cord compression due to thoracic extramedullary haematopoiesis in myelofibrosis. Neuroradiology. 39(10):733-6, 1997
                                                                                          16. Kalina P et al: Cord compression by extramedullary hematopoiesis in polycythemia vera. AJR Am J Roentgenol. 164(4):1027-8, 1995
                                                                                          17. Papavasiliou C: Clinical expressions of the expansion of the bone marrow in the chronic anemias: the role of radiotherapy. Int J Radiat Oncol Biol Phys. 28(3):605-12, 1994
                                                                                          18. Kalina P et al: MR of extramedullary hematopoiesis causing cord compression in beta-thalassemia. AJNR Am J Neuroradiol. 13(5):1407-9, 1992
                                                                                          19. Konstantopoulos K et al: A case of spinal cord compression by extramedullary haemopoiesis in a thalassaemic patient: a putative role for hydroxyurea? Haematologica. 77(4):352-4, 1992
                                                                                          20. Gouliamos A et al: Low back pain due to extramedullary hemopoiesis. Neuroradiology. 33(3):284-5, 1991
                                                                                          21. Kaufmann T et al: The role of radiation therapy in the management of hematopoietic neurologic complications in thalassemia. Acta Haematol. 85(3):156-9, 1991
                                                                                          22. Papavasiliou C et al: Masses of myeloadipose tissue: radiological and clinical considerations. Int J Radiat Oncol Biol Phys. 19(4):985-93, 1990