Fine Needle Aspiration Diagnosis of Extramedullary Hematopoiesis Resembling Mediastinal and Paravesical Tumors

Sáenz-Santamaría, Javier; Catalina-Fernández, Inmaculada

doi:10.1159/000326292

Cited by 11 publications

(14 citation statements)

References 10 publications

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“…EMH is usually related to ineffective hematopoiesis in the bone marrow, most commonly seen in chronic myeloproliferative disorders (primary myelofibrosis/agnogenic myeloid metaplasia, polycythemia vera, essential thrombocythemia and chronic myelogenous leukemia), myelodysplasia, hemoglobinopathies (the most common are thalassemia and sickle-cell anemia) and myelophthisic anemia caused by bone marrow infiltration by metastatic carcinoma [7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26]. EMH has also been rarely identified in unexpected settings such as in mechanical valves [4] and myocardial infarction [27].…”

Section: Discussionmentioning

confidence: 99%

Extramedullary Hematopoiesis: Cytomorphologic, Histologic, and Radiologic Findings in Sixteen Cases

Sheikh

Rodić

Maleki³

2015

Acta Cytologica

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Background: We report a case series of extramedullary hematopoiesis (EMH) diagnosed from the fine needle aspiration (FNA) procedure. Unanticipated EMH is a markedly rare diagnosis that typically presents as a solitary mass of undetermined significance. As such, knowledge of cytopathologic characteristics as well as clinical and radiologic correlates of EMH is paramount. Method and Material: A total of 16 EMH cytopathologic cases were seen at the Johns Hopkins Hospital in the past 22 years. Results: Median age at diagnosis was 61 years and there was no gender bias (male-to-female ratio: 1:1). Presenting signs and symptoms varied widely, from incidental radiographic findings to hemiparesis. Likewise, presumptive clinical diagnoses in 11 of the 16 cases were benign and the other 5 were considered malignant prior to the diagnostic FNA. The most common anatomic site for EMH was the liver, followed by the presacral soft tissue and pleura. While most EMH nodules were singular, a few presented with as many as three radiographically distinct nodules. The average EMH nodule measured 2.8 cm; the EMH liver nodules were larger and measured 4.3 cm on average (p = 0.0043). Conclusion: We share here the salient clinical and radiologic findings and the diagnostic cytopathologic features of EMH in an effort to familiarize the pathologist/cytotechnologist community with this fascinating albeit rare entity.

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Section: Discussionmentioning

confidence: 99%

Extramedullary Hematopoiesis: Cytomorphologic, Histologic, and Radiologic Findings in Sixteen Cases

Sheikh

Rodić

Maleki³

2015

Acta Cytologica

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“…Cytological findings of tumour-like EMH in a variety of sites have been reported. [1][2][3][4][5][9][10][11][12][13][14] The cytological appearance of EMH consists of a tri-lineage population of precursor haemopoietic cells, including megakaryocytes, erythrocytes and granulocytes. Often one cell line will dominate.…”

Section: Fine Needle Aspiration Of An Axillary Lymph Nodementioning

confidence: 99%

“…EMH can be distinguished from granulocytic sarcoma by the presence of erythroid precursors and megakaryocytes. 3,11,12,27,28 Finally, EMH can be mistaken for lymphomas, such as Hodgkin's disease. Rarely, an atypical megakaryocyte can mimic a Reed-Sternberg cell.…”

Section: Fine Needle Aspiration Of An Axillary Lymph Nodementioning

confidence: 99%

“…5 The cytological appearance of EMH obtained via FNA has been reported in the literature. [1][2][3][4][5][9][10][11][12][13][14] However, the cytological diagnosis of acute leukaemia/chloroma in the background of EMH in a patient with polycythaemia vera by FNA is highly uncommon. We report a case of axillary lymph node EMH diagnosed by FNA, occurring in a patient with PV.…”

Section: Introductionmentioning

confidence: 99%

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Fine needle aspiration of an axillary lymph node in a patient suspected of having metastatic cancer of unknown primary

Meara¹,

Jhala²,

Eltoum³

et al. 2008

Cytopathology

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“…The most common site of EMH is the reticuloendothelial system, namely within the spleen, liver or lymph nodes [1, 2]. However, EMH can involve any organ or tissue thus mimicking a solid tumor or lymphoma [1,2,3]. …”

Section: Introductionmentioning

confidence: 99%

Unusual Manifestations of Myelofibrosis in a Patient with Congenital Asplenia

Almoznino‐Sarafian

Dotan²,

Sandbank³

et al. 2007

Acta Haematol

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Fine Needle Aspiration Diagnosis of Extramedullary Hematopoiesis Resembling Mediastinal and Paravesical Tumors

Cited by 11 publications

References 10 publications

Extramedullary Hematopoiesis: Cytomorphologic, Histologic, and Radiologic Findings in Sixteen Cases

Extramedullary Hematopoiesis: Cytomorphologic, Histologic, and Radiologic Findings in Sixteen Cases

Fine needle aspiration of an axillary lymph node in a patient suspected of having metastatic cancer of unknown primary

Unusual Manifestations of Myelofibrosis in a Patient with Congenital Asplenia

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