Musculoskeletal
MSK Protocols
Signa GE 1.5 T LX 9.1 protocols
MR Information
MSK Procedures
Referring Providers
Extramedullary Hematopoiesis
by Peter Glickman, MD
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This case represents a distinctly unusual location for EMH, which is more typically seen in the ribs, vertebral bodies, and pelvis. The process represents recruitment of additional sites of bone marrow for the production of blood elements in situations of increased demand such as anemias and hematologic malignancies, in this case AML. The radiograph shows multiple well defined expansile lytic lesions with mineralization of adjacent soft tissue masses, and resembles a moderately aggressive process. The MR shows well defined enhancing masses expanding out from the medullary cavity of the humerus. There is no way to distinguish this appearance from a neoplastic process such as sarcoma, lymphoma, or carcinoma and the patient therefore underwent a biopsy for tissue diagnosis.
The accompanying abdominal CT shows splenomegaly with splenic lesions, lymphadenopathy, and heterogeneous densities in the bony pelvis, all of which is likely related to the patient’s underlying condition. There is also an adrenal mass, which is indeterminate.