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Extramedullary Hematopoiesis
Kevin R. Moore, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            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. 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
                                            2. 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
                                            3. Hassanzadeh M: Images in clinical medicine. Extramedullary hematopoiesis in thalassemia. N Engl J Med. 369(13):1252, 2013
                                            4. Haidar R et al: Paraspinal extramedullary hematopoiesis in patients with thalassemia intermedia. Eur Spine J. 19(6):871-8, 2010
                                            5. 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
                                            6. Singh S et al: Paraspinal extramedullary hematopoiesis diagnosed using Tc-99m sulfur colloid. Clin Nucl Med. 33(11):794-6, 2008
                                            7. Salehi SA et al: Spinal cord compression in beta-thalassemia: case report and review of the literature. Spinal Cord. 42(2):117-23, 2004
                                            8. 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
                                            9. Koch CA et al: Nonhepatosplenic extramedullary hematopoiesis: associated diseases, pathology, clinical course, and treatment. Mayo Clin Proc. 78(10):1223-33, 2003
                                            10. Cario H et al: Treatment with hydroxyurea in thalassemia intermedia with paravertebral pseudotumors of extramedullary hematopoiesis. Ann Hematol. 81(8):478-82, 2002
                                            11. Chourmouzi D et al: MRI findings of extramedullary haemopoiesis. Eur Radiol. 11(9):1803-6, 2001
                                            12. Aydingoz U et al: Spinal cord compression due to epidural extramedullary haematopoiesis in thalassaemia: MRI. Neuroradiology. 39(12):870-2, 1997
                                            13. 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
                                            14. Guermazi A et al: Imaging of spinal cord compression due to thoracic extramedullary haematopoiesis in myelofibrosis. Neuroradiology. 39(10):733-6, 1997
                                            15. Kalina P et al: Cord compression by extramedullary hematopoiesis in polycythemia vera. AJR Am J Roentgenol. 164(4):1027-8, 1995
                                            16. 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
                                            17. 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

                                                      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. 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
                                                                                      2. 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
                                                                                      3. Hassanzadeh M: Images in clinical medicine. Extramedullary hematopoiesis in thalassemia. N Engl J Med. 369(13):1252, 2013
                                                                                      4. Haidar R et al: Paraspinal extramedullary hematopoiesis in patients with thalassemia intermedia. Eur Spine J. 19(6):871-8, 2010
                                                                                      5. 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
                                                                                      6. Singh S et al: Paraspinal extramedullary hematopoiesis diagnosed using Tc-99m sulfur colloid. Clin Nucl Med. 33(11):794-6, 2008
                                                                                      7. Salehi SA et al: Spinal cord compression in beta-thalassemia: case report and review of the literature. Spinal Cord. 42(2):117-23, 2004
                                                                                      8. 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
                                                                                      9. Koch CA et al: Nonhepatosplenic extramedullary hematopoiesis: associated diseases, pathology, clinical course, and treatment. Mayo Clin Proc. 78(10):1223-33, 2003
                                                                                      10. Cario H et al: Treatment with hydroxyurea in thalassemia intermedia with paravertebral pseudotumors of extramedullary hematopoiesis. Ann Hematol. 81(8):478-82, 2002
                                                                                      11. Chourmouzi D et al: MRI findings of extramedullary haemopoiesis. Eur Radiol. 11(9):1803-6, 2001
                                                                                      12. Aydingoz U et al: Spinal cord compression due to epidural extramedullary haematopoiesis in thalassaemia: MRI. Neuroradiology. 39(12):870-2, 1997
                                                                                      13. 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
                                                                                      14. Guermazi A et al: Imaging of spinal cord compression due to thoracic extramedullary haematopoiesis in myelofibrosis. Neuroradiology. 39(10):733-6, 1997
                                                                                      15. Kalina P et al: Cord compression by extramedullary hematopoiesis in polycythemia vera. AJR Am J Roentgenol. 164(4):1027-8, 1995
                                                                                      16. 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
                                                                                      17. Kalina P et al: MR of extramedullary hematopoiesis causing cord compression in beta-thalassemia. AJNR Am J Neuroradiol. 13(5):1407-9, 1992