Lege Artis Medicinae

[Extensive retroperitoneal extramedullary hematopoiesis mimicking disseminated abdominal cancer]

KŐVÁRI Bence, DONKÓ Veronika, PIUKOVICS Klára

APRIL 20, 2016

Lege Artis Medicinae - 2016;26(04)

[INTRODUCTION - Myelofibrosis is a type of chronic myeloproliferative neoplasia frequently associated with extramedullary hematopoiesis. This latter process usually affects the spleen and the liver, and should be designated as nonhepatosplenic extramedullary hematopoiesis if it involves other organs. Nonhepatosplenic extramedullary hematopoiesis is reported to be more common in patients who had splenectomy. CASE REPORT - A 66-year-old woman with 5-year history of myelofibrosis was hospitalized eight month prior to death due to increasing abdominal effusion, abdominal discomfort and dyspnea. Three years before death, splenectomy was performed. The abdominal imaging studies disclosed a circumscribed tumorous mass in the pancreas, with enlargement of the peripancreatic lymph nodes. The lesion interpreted as pancreatic cancer progressed and the patient died. Post mortem histological evaluation confirmed the abdominal mass to represent myeloid metaplasia of the retroperitoneal fat tissue. CONCLUSIONS - Besides the possibility of a secondary primary tumor, the discovery of a novel mass lesion in patients with myelofibrosis should raise the suspicion of extramedullary hematopoiesis, especially when the patient had splenectomy.]

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