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Extramedullary Hematopoiesis
Kevin R. Moore, 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. Kapatia G et al: Extramedullary hematopoiesis: clinical and cytological features. Diagn Cytopathol. 48(3):191-6, 2020
                                              2. Yang X et al: The mechanisms of pathological extramedullary hematopoiesis in diseases. Cell Mol Life Sci. ePub, 2020
                                              3. Ismail II et al: Compressive dorsal myelopathy secondary to extramedullary hematopoiesis in a thalassemic patient. Case Rep Neurol Med. 2019:5827626, 2019
                                              4. Nguyen GT et al: Nonanemic extramedullary hematopoiesis in the posterior mediastinum. Asian Cardiovasc Thorac Ann. 27(2):135-7, 2019
                                              5. Hisamud-Din N et al: Incomplete paraplegia caused by extramedullary hematopoiesis in a patient with thalassemia intermedia. Spinal Cord Ser Cases. 3:17020, 2017
                                              6. Ruo Redda MG et al: Complete recovery from paraparesis in spinal cord compression due to extramedullary haemopoiesis in beta-thalassaemia by emergency radiation therapy. Intern Med J. 44(4):409-12, 2014
                                              7. Ghieda U et al: Progressive spinal cord compression due to epidural extramedullary hematopoiesis in thalassemia intermedia. A case report and literature review. Neuroradiol J. 26(1):111-7, 2013
                                              8. Hassanzadeh M: Images in clinical medicine. Extramedullary hematopoiesis in thalassemia. N Engl J Med. 369(13):1252, 2013
                                              9. Haidar R et al: Paraspinal extramedullary hematopoiesis in patients with thalassemia intermedia. Eur Spine J. 19(6):871-8, 2010
                                              10. 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
                                              11. Singh S et al: Paraspinal extramedullary hematopoiesis diagnosed using Tc-99m sulfur colloid. Clin Nucl Med. 33(11):794-6, 2008
                                              12. Salehi SA et al: Spinal cord compression in beta-thalassemia: case report and review of the literature. Spinal Cord. 42(2):117-23, 2004
                                              13. Chehal A et al: Hypertransfusion: a successful method of treatment in thalassemia intermedia patients with spinal cord compression secondary to extramedullary hematopoiesis. Spine. 28(13):E245-9, 2003
                                              14. Koch CA et al: Nonhepatosplenic extramedullary hematopoiesis: associated diseases, pathology, clinical course, and treatment. Mayo Clin Proc. 78(10):1223-33, 2003
                                              15. Cario H et al: Treatment with hydroxyurea in thalassemia intermedia with paravertebral pseudotumors of extramedullary hematopoiesis. Ann Hematol. 81(8):478-82, 2002
                                              16. Chourmouzi D et al: MRI findings of extramedullary haemopoiesis. Eur Radiol. 11(9):1803-6, 2001
                                              17. Aydingoz U et al: Spinal cord compression due to epidural extramedullary haematopoiesis in thalassaemia: MRI. Neuroradiology. 39(12):870-2, 1997
                                              18. 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
                                              19. Guermazi A et al: Imaging of spinal cord compression due to thoracic extramedullary haematopoiesis in myelofibrosis. Neuroradiology. 39(10):733-6, 1997
                                              20. Kalina P et al: Cord compression by extramedullary hematopoiesis in polycythemia vera. AJR Am J Roentgenol. 164(4):1027-8, 1995
                                              21. 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
                                              22. Kalina P et al: MR of extramedullary hematopoiesis causing cord compression in beta-thalassemia. AJNR Am J Neuroradiol. 13(5):1407-9, 1992
                                              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. Kapatia G et al: Extramedullary hematopoiesis: clinical and cytological features. Diagn Cytopathol. 48(3):191-6, 2020
                                                                                          2. Yang X et al: The mechanisms of pathological extramedullary hematopoiesis in diseases. Cell Mol Life Sci. ePub, 2020
                                                                                          3. Ismail II et al: Compressive dorsal myelopathy secondary to extramedullary hematopoiesis in a thalassemic patient. Case Rep Neurol Med. 2019:5827626, 2019
                                                                                          4. Nguyen GT et al: Nonanemic extramedullary hematopoiesis in the posterior mediastinum. Asian Cardiovasc Thorac Ann. 27(2):135-7, 2019
                                                                                          5. Hisamud-Din N et al: Incomplete paraplegia caused by extramedullary hematopoiesis in a patient with thalassemia intermedia. Spinal Cord Ser Cases. 3:17020, 2017
                                                                                          6. Ruo Redda MG et al: Complete recovery from paraparesis in spinal cord compression due to extramedullary haemopoiesis in beta-thalassaemia by emergency radiation therapy. Intern Med J. 44(4):409-12, 2014
                                                                                          7. Ghieda U et al: Progressive spinal cord compression due to epidural extramedullary hematopoiesis in thalassemia intermedia. A case report and literature review. Neuroradiol J. 26(1):111-7, 2013
                                                                                          8. Hassanzadeh M: Images in clinical medicine. Extramedullary hematopoiesis in thalassemia. N Engl J Med. 369(13):1252, 2013
                                                                                          9. Haidar R et al: Paraspinal extramedullary hematopoiesis in patients with thalassemia intermedia. Eur Spine J. 19(6):871-8, 2010
                                                                                          10. 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
                                                                                          11. Singh S et al: Paraspinal extramedullary hematopoiesis diagnosed using Tc-99m sulfur colloid. Clin Nucl Med. 33(11):794-6, 2008
                                                                                          12. Salehi SA et al: Spinal cord compression in beta-thalassemia: case report and review of the literature. Spinal Cord. 42(2):117-23, 2004
                                                                                          13. Chehal A et al: Hypertransfusion: a successful method of treatment in thalassemia intermedia patients with spinal cord compression secondary to extramedullary hematopoiesis. Spine. 28(13):E245-9, 2003
                                                                                          14. Koch CA et al: Nonhepatosplenic extramedullary hematopoiesis: associated diseases, pathology, clinical course, and treatment. Mayo Clin Proc. 78(10):1223-33, 2003
                                                                                          15. Cario H et al: Treatment with hydroxyurea in thalassemia intermedia with paravertebral pseudotumors of extramedullary hematopoiesis. Ann Hematol. 81(8):478-82, 2002
                                                                                          16. Chourmouzi D et al: MRI findings of extramedullary haemopoiesis. Eur Radiol. 11(9):1803-6, 2001
                                                                                          17. Aydingoz U et al: Spinal cord compression due to epidural extramedullary haematopoiesis in thalassaemia: MRI. Neuroradiology. 39(12):870-2, 1997
                                                                                          18. 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
                                                                                          19. Guermazi A et al: Imaging of spinal cord compression due to thoracic extramedullary haematopoiesis in myelofibrosis. Neuroradiology. 39(10):733-6, 1997
                                                                                          20. Kalina P et al: Cord compression by extramedullary hematopoiesis in polycythemia vera. AJR Am J Roentgenol. 164(4):1027-8, 1995
                                                                                          21. 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
                                                                                          22. Kalina P et al: MR of extramedullary hematopoiesis causing cord compression in beta-thalassemia. AJNR Am J Neuroradiol. 13(5):1407-9, 1992