Bilateral Pleural Effusion in a Patient with an Extensive Extramedullary Hematopoietic Mass

Abstract

We present a 56-year-old woman with bilateral pleural effusions, widespread enlarged lymph nodes, and soft tissue masses located within the renal pelvis. The initially working diagnosis was tuberculosis and lymphoma. Further pathological examination of the lymph node biopsy confirmed a diagnosis of extramedullary hematopoiesis, and a bone marrow biopsy revealed myelofibrosis. Unlike common treatment options such as radiotherapy and/or surgery, intrathoracic cisplatin and dexamethasone for the treatment of pleural effusions secondary to extramedullary hematopoiesis demonstrated an improvement in feasibility and efficacy in the present case.

Cytodiagnosis of extramedullary hematopoiesis in serous effusion: A rare presentation unfolding the underlying etiology

“…EMH in serous fluids has been reported rarely with few case reports in literature. [ 3 4 5 6 7 ] EMH in pleural fluid is more rare than in peritoneal fluid. In our case, both peritoneal and pleural fluid involvement was seen with EMH.…”

“…Luo et al . [ 5 ] reported similar case of bilateral pleural effusion in a patient with extensive EMH where the clinical presentation mimicked tuberculosis.…”

“…The presence of ascites and pleural effusion is not frequently seen with myelofibrosis which was possibly the cause for not suspecting a myeloproliferative disorder primarily. [ 5 ] Very few cases have been reported in literature which describe the cytologic findings of EMH in patients with myelofibrosis and having both peritoneal and pleural effusion. [ 5 6 7 8 ]…”