A case of perirenal extramedullary hematopoiesis in a patient with primary myelofibrosis

Abstract

Extramedullary hematopoiesis (EMH) is hematopoiesis in organs outside the bone marrow and most frequently occurs in the liver, spleen, and lymph nodes. We report a case of perirenal EMH revealed by kidney biopsy in a patient with primary myelofibrosis. We observed only bilateral kidney enlargement with plain computed tomography (CT) and ultrasonography before obtaining a renal biopsy. We obtained a percutaneous biopsy from the lower pole of the left kidney using ultrasonographic guidance. Ultrasonography just after the renal biopsy revealed no bleeding around the kidney. However, early the next morning, the patient developed severe hemorrhagic shock. Contrast-enhanced CT at that time revealed a massive hematoma in the left posterior perirenal space and bilateral abnormalities of the perirenal soft tissues. In patients with primary myelofibrosis, if plain CT shows an abnormal renal enlargement, EMH should be considered. In addition, a contrast-enhanced CT should be obtained before performing a percutaneous renal biopsy to assess for the possibility of perirenal EMH in these patients.

Renal Extramedullary Hematopoiesis in Mast Cell Leukemia with Bone Marrow Fibrosis

“…Te extramedullary hematopoiesis therefore follows a long and chronic disease course with progressive BM fbrosis. Renal/pararenal extramedullary hematopoiesis is a rare fnding, which is in most cases accompanied by renal failure [15] and usually associated with hematologic disease other than SM, most commonly MPNs [15][16][17]. Extramedullary hematopoiesis has been described in about 20% of patients with SM [18], even though renal extramedullary hematopoiesis has, to the best of our knowledge, not been described in MCL.…”

Bilateral Huge Perirenal Angiomyolipoma: Conservative Management of a Time Bomb

“…In such cases, a bone marrow biopsy is indicated. The establishment of Myelofibrosis and myeloid Metaplasia helps distinguish these two entities (6).…”