å¡ CASE REPORT å¡ Thoracic Extramedullary Hematopoiesis Associated with Hereditary Spherocytosis Takashi Abe, Akira Yachi, Yoshiroh Ishii, Tomofumi Igarashi, Hiroshi Tanaka, Yutaka Yoshida, Matsumi Tosaka, Fumitoshi Ishibashi, Kazuhiko Yonezawa, Akihiro Ono, Shigeru Sasaki, Atsushi Yawata and Tetsuya Tokunoh A 54-year-old man was diagnosed with hereditary spherocytosis. An X-ray of the chest disclosed bilateral round masses in the upper and lower posterior mediastinum. CT showed homogeneous round masses of soft tissue density in the posterior mediastinum. A needle biopsy of the mass showed hyperplastic erythroid bone marrow. Fatty metamorphosis of the masses was observed in CT 2 years after splenectomy but showed no change in size. (Internal Medicine 31: 1151-1154, 1992) Key words: fatty metamorphosis, needle biopsy
Introduction Thoracic extramedullary hematopoiesis (EMH) associated with hereditary spherocytosis (HS) is a rare phenomenon, with only 21 cases having been reported (1-19). We report a patient with this disorder, in whom the disorder was indicated by chest X-ray, CT, and mIn chloride scintigram and confirmed by needle biopsy. Fatty transformation of the hematopoietic tissue was demonstrated 2 years after splenectomy. The other 21 cases are reviewed. Case Report A 54-year-old man was admitted to Kushiro City General Hospital because of anemia and jaundice in July 1987. Past history revealed anemia from the age of 20 years. No treatment other than blood transfusion in an other hospital had been performed. His two brothers and a son hadexamination been recognized to have hemolytic anemia. Physical revealed anemia and hepatosple nomegaly. Laboratory findings were compatible with HS : RBC; 273 x lO4//4 Hb; 9.0g/dl, Ht; 27.2%, reticulo cyte; 270%o, indirect bilirubin; 5.4mg/dl, haptoglobin
Introduction Thoracic extramedullary hematopoiesis (EMH) associated with hereditary spherocytosis (HS) is a rare phenomenon, with only 21 cases having been reported (1-19). We report a patient with this disorder, in whom the disorder was indicated by chest X-ray, CT, and mIn chloride scintigram and confirmed by needle biopsy. Fatty transformation of the hematopoietic tissue was demonstrated 2 years after splenectomy. The other 21 cases are reviewed. Case Report A 54-year-old man was admitted to Kushiro City General Hospital because of anemia and jaundice in July 1987. Past history revealed anemia from the age of 20 years. No treatment other than blood transfusion in an other hospital had been performed. His two brothers and a son hadexamination been recognized to have hemolytic anemia. Physical revealed anemia and hepatosple nomegaly. Laboratory findings were compatible with HS : RBC; 273 x lO4//4 Hb; 9.0g/dl, Ht; 27.2%, reticulo cyte; 270%o, indirect bilirubin; 5.4mg/dl, haptoglobin
