Extramedullary hematopoiesis in the adrenal: Case report and review of literature

Banerji, John S.; Kumar, Rajesh; Devasia, Antony

doi:10.5489/cuaj.1389

Cited by 20 publications

(17 citation statements)

References 8 publications

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“…EMH can be seen in hematologic diseases such as hemoglobinopathies, myeloproliferative disorders, lymphomas, leukemia, and hemolytic anemias (4,5). EMH commonly occurs outside of the bone marrow in the reticuloendothelial system such as the spleen and liver, but can rarely be seen in organs such as brain, adrenals, pleura, bowel, and breast (7)(8)(9)(10). EMH in the adrenals is rare and is thought to be a compensatory mechanism secondary to altered hematopoiesis in patients with hemolytic disorders (8).…”

Section: Discussionmentioning

confidence: 99%

“…EMH commonly occurs outside of the bone marrow in the reticuloendothelial system such as the spleen and liver, but can rarely be seen in organs such as brain, adrenals, pleura, bowel, and breast (7)(8)(9)(10). EMH in the adrenals is rare and is thought to be a compensatory mechanism secondary to altered hematopoiesis in patients with hemolytic disorders (8). A few cases of EMH involving the adrenal glands have been reported in patients with SCD, beta-thalassemia, and hereditary spherocytosis (5,(7)(8)(9).…”

Section: Discussionmentioning

confidence: 99%

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A Rare Case of Rapidly Enlarging Myelolipoma in Sickle Cell Disease

Davari

Lee

2020

AACE Clinical Case Reports

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Objective: Adrenal myelolipoma (AM) is a benign tumor composed of mature fat cells and hemopoietic elements. Most AMs are incidental findings on imaging and clinically asymptomatic. The purpose of this case report is to describe a rare case of AM and explore its clinical manifestations, imaging features, and treatment. Methods: In this study, we report a case of a rapidly growing right AM in a patient with uncontrolled hemoglobin sickle cell disease. A 38-year-old male presented to our institution's endocrine surgery clinic for evaluation of an enlarging right adrenal mass. This mass was incidentally found during an abdominal ultrasound performed for transaminitis and thrombocytopenia. Patient was asymptomatic without any abdominal discomfort, back pain, nausea, or vomiting. Results: Patient was lost to follow up until 2018. Follow-up computed tomography scan in 2018 showed the right adrenal mass measuring 12.3 cm in greatest dimension with significant macroscopic fat. Given the imaging features, AM was the presumed diagnosis. However, with a medical history of uncontrolled sickle cell disease, extra-medullary hematopoiesis and rapidly growing liposarcoma could not be ruled out. Surgical excision was performed due to size and significant tumor growth. Diagnosis was confirmed with histopathology and revealed myelolipoma. Conclusion: Image characteristics can be helpful in diagnosis of AM; however, the appearance of this lesion on computed tomography can be similar to other adrenal gland pathologies such as liposarcoma and mass-forming extramedullary hematopoiesis. Percutaneous needle biopsy may be indicated if the diagnosis remains unclear.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A Rare Case of Rapidly Enlarging Myelolipoma in Sickle Cell Disease

Davari

Lee

2020

AACE Clinical Case Reports

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“…Karami et al 6 reported a patient with clinically palpable asymptomatic adrenal mass, whereas Calhoun et al 7 and Porcaro et al 8 reported patients with incidentally detected adrenal masses on ultrasonography. Lau et al 5 and Banerji et al 9 reported patients presenting with abdominal pain and found to have adrenal masses on imaging. All these patients remained undiagnosed after imaging or biochemical evaluation and underwent diagnostic adrenalectomy.…”

Section: Discussionmentioning

confidence: 99%

Adrenal incidentaloma caused by extramedullary haematopoiesis: conservative management is optimal

et al. 2015

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SUMMARYWe present a thalassaemic patient with extramedullary haematopoiesis in the adrenal gland, which is one of the rare sites of involvement. A 29-year-old man presented with a history of anaemia since childhood which required blood transfusion recently. On examination, he had pallor, icterus and splenomegaly with no other palpable abdominal mass. He was diagnosed to have β-thalassaemia. Ultrasonography of the abdomen showed an incidental right adrenal mass with splenomegaly; CT revealed a large right adrenal mass with heterogeneous density. Adrenal adenoma, carcinoma and extramedullary haematopoiesis were considered in the differential diagnosis. After excluding a functioning tumour, the diagnosis was confirmed by ultrasound-guided biopsy. Since the patient was asymptomatic, the adrenal lesion was managed conservatively. BACKGROUND

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“…Patients with adrenal EMH are generally known to have major bthalassemia or other major hemoglobinopathies. When facing an adrenal mass, the size criteria is an important feature for making a decision (7). Masses larger than 6 cm should be considered malignant, until proven otherwise (8).…”

Section: Discussionmentioning

confidence: 99%

Extramedullary Hematopoiesis in a Man With β-Thalassemia: An Uncommon Cause of an Adrenal Mass

Zeighami

Eslahi²,

Hosseini

et al. 2015

Ann Colorectal Res

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Introduction: Extramedullary hematopoiesis (EMH) commonly occurs in the spleen, liver and lymph nodes. Rare cases of EMH in the adrenal gland have been reported. Case Presentation: We report the case of a 33-year-old man from the South of Iran suffering from major β-thalassemia, who underwent open left adrenalectomy and the histopathology revealed EMH. Conclusions:In patients in which a history of hematologic disorders exists, careful imaging and hormonal assay should be done to certify a diagnosis of EMH. However, the surgical management becomes inevitable in certain cases.

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Extramedullary hematopoiesis in the adrenal: Case report and review of literature

Abstract: case report E436Cite as: Can Urol Assoc J 2013;7(5-6):e436-8. http://dx

Cited by 20 publications

References 8 publications

A Rare Case of Rapidly Enlarging Myelolipoma in Sickle Cell Disease

A Rare Case of Rapidly Enlarging Myelolipoma in Sickle Cell Disease

Adrenal incidentaloma caused by extramedullary haematopoiesis: conservative management is optimal

Extramedullary Hematopoiesis in a Man With β-Thalassemia: An Uncommon Cause of an Adrenal Mass

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