A surgical case of extramedullary hematopoiesis in the bilateral posterior mediastinum

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  • Higuchi Mitsunori
    Department of Thoracic Surgery, Aizu Medical Center, Fukushima Medical University
  • Watanabe Masayuki
    Department of Thoracic Surgery, Aizu Medical Center, Fukushima Medical University Department of Chest Surgery, Fukushima Medical University School of Medicine
  • Oshibe Ikuro
    Department of Surgery, Aizu Medical Center, Fukushima Medical University
  • Soeta Nobutoshi
    Department of Surgery, Aizu Medical Center, Fukushima Medical University
  • Saito Takuro
    Department of Surgery, Aizu Medical Center, Fukushima Medical University
  • Suzuki Hiroyuki
    Department of Chest Surgery, Fukushima Medical University School of Medicine

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  • 両側後縦隔原発の髄外造血巣の1手術例

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Abstract

<p>We report the case of a 72-year-old male with intrathoracic extramedullary hematopoiesis. During treatment for a cough, CT incidentally revealed bilateral posterior mediastinal tumors of 32 mm at the right Th9 level and 33 mm at the left Th11 level. He underwent extirpation of the right tumor under video-assisted thoracic surgery (VATS) for a preoperatively suspected neurogenic tumor. The tumor was dark red and so soft and fragile that it was prone to hemorrhage. Pathological findings revealed hypercellular marrow with granulocytes, megakaryocytes, and erythrocytes, and the patient was diagnosed with extramedullary hematopoiesis. Postoperative biopsy of bone marrow showed hypocellular marrow; however, we did not detect abnormal cells or hematological abnormalities. We performed postoperative bone marrow scintigraphy with 111In to evaluate the contralateral tumor, and found the accumulation of 111In in the left tumor. The patient recovered well without recurrence of the right mass or growth of the left tumor for 12 months post-surgery. Our case demonstrates that if bilateral posterior mediastinal tumors are detected on CT, then extramedullary hematopoiesis should be considered and evaluated by hematological testing.</p>

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