A case of posterior mediastinal massforming extramedullary hematopoiesis, associated with Thalassemia.

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  • サラセミアに合併した後縦隔髄外造血巣の１例

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Abstract

Background: Extramedullary hematopoiesis (EMH) may arise in compensation for reduction in hematopoiesis associated with severe chronic anemia, leukemia or some other conditions. These lesions generally occur in the liver, spleen, adrenal, and rarely in soft tissue. In the present study, we report a case of EMH associated with thalassemia.<BR>Case: A 47-year-old woman was noted to have a mass confined in the posterior mediastinum on chest X-ray at medical checkup 2 years before admission. The patient was admitted to our hospital because the mass was markedly enlarged. At MRI, a hemispherical mass, measuring about 4cm, was detected at the right edge of the thoracic vertebra. The mass was resected.<BR>By Giemsa-stained imprint smear, cytological findings were similar to those of the normal bone marrow. On Papanicolaou stain, the following cells were identified: megakaryocytes which appeared as giant cells with abundant cytoplasm and a lobulated nuclei or with naked nuclei, orthochromic erythroblasts which appeared as small cells with cytoplasm stained by lightgreen or orange G and pyknotic nuclei, and granulocytes with horseshoe-shaped nuclei or segmented nuclei.<BR>Conclusion: Although EMH located on the mediastinum is extremely rare, imprint cytology has diagnostic value if the patient suffers from severe hematopoietic disorders such as thalassemia.

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