Chest
Selected ReportsMassive Hemothorax Associated with Intrathoracic Extramedullary Hematopoiesis Involving the Pleura
Section snippets
CASE REPORT
A 73-year-old woman with a history of myelofibrosis diagnosed 7 years earlier presented with dyspnea and a right-sided pleural effusion. Sanguineous fluid (1,000 ml) was removed, after which her symptoms improved. The pleural fluid was an exudate and had an RBC of 0.13 × 1012VL, a WBC of 5.5 × 109/L (63 percent neutrophils, 11 percent lymphocytes, 7 percent eosinophils, 3 percent metamyelocytes, 9 percent myelocytes, and 4 percent promyelocytes), and a hematocrit reading of less than 2 percent.
DISCUSSION
Intrathoracic extramedullary hematopoiesis is typically asymptomatic unless it causes symptoms from compression of nearby structures, such as the spinal cord.2, 5 In our patient, the extramedullary hematopoietic tissue involved the pleura, resulting in a massive hemothorax. Pleural extramedullary hematopoiesis in myelofibrosis has been described previously,4 but these patients did not have respiratory symptoms, and the diagnosis was made at autopsy. In one other case report,6 massive hemothorax
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Invasive methods for the diagnosis and management of intrathoracic extramedullary hematopoiesis: A literature review
2021, Respiratory Medicine and ResearchExtramedullary Hematopoiesis Mimicking Mediastinal Tumor in a Patient with Hereditary Spherocytosis: Case report
2017, International Journal of Surgery Case ReportsCitation Excerpt :The most common sites of EMH are liver and spleen, but it has been documented in other organs such as the mediastinum, lymph nodes, breast, and central nervous system [1]. Among them, intrathoracic EMH is commonly encountered as a mass in the posteroinferior mediastinum, though there have been a few reports of the anterior mediastinum or pleura [2]. In patients with a medical history of neoplastic or hematologic disorders presenting with intrathoracic mass, a diagnosis of EMH should be considered in the differential diagnosis.
Recurrent spontaneous massive hemothorax from intrathoracic extramedullary hematopoiesis resulting in respiratory failure
2015, Journal of the Formosan Medical AssociationCitation Excerpt :Chute et al reported the first fatal hemothorax from spontaneous rupture of intrathoracic EMH in 2004.4 Kupferschmid et al reported a case of myelofibrosis with intrathoracic EMH.5 This complicated massive hemothorax did not respond to tetracycline pleurodesis and was ultimately controlled with low-dose radiation therapy.
Non-infectious pulmonary complications of myelodysplastic syndromes and chronic myeloproliferative disorders
2011, Revue des Maladies RespiratoiresIntrathoracic Extramedullary Haematopoiesis Manifested as a Neoplastic Lesion Within Anterior Mediastinum
2009, Annals of Thoracic SurgeryCitation Excerpt :Intrathoracic EMH, the formation of appearently normal blood cells outside the confines of the bone marrow is uncommon, but is a well-defined entity [1]. It is usually asymptomatic and located in the lower paravertebral sulci or rarely in the pleura [2]. If hematologic disorder and radiologic evidence of myelofibrosis are present, EMH is easy to diagnose.
Non-infectious pulmonary complications of myelodysplastic syndromes and chronic myeloproliferative disorders
2009, Revue des Maladies Respiratoires
†Presently at the Department of Thoracic and Cardiovascular Surgery, University Hospital, Boston.