Progressive Spinal Cord Compression Due to Epidural Extramedullary Hematopoiesis in Thalassemia Intermedia

Ghieda, Usama Elsaied; Elshimy, M.; Beltagi, Ahmed El

doi:10.1177/197140091302600119

Cited by 16 publications

(6 citation statements)

References 38 publications

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“…5 There are multiple reports of spinal cord compression due to extramedullary hematopoietic tumors in people afflicted with severe anemia, most commonly attributed to beta-thalassemia. [13][14][15][16] Similar findings were recently reported in a domestic shorthaired cat with chronic nonregenerative anemia and probable myelodysplasia. 17 In contrast, myelolipomas are not associated with hematologic disorders and tend to occur in significantly older patients.…”

supporting

confidence: 86%

“…In people, extramedullary hematopoietic tumors are typically located within the mediastinum or epidural space 5 . There are multiple reports of spinal cord compression due to extramedullary hematopoietic tumors in people afflicted with severe anemia, most commonly attributed to beta‐thalassemia 13–16 . Similar findings were recently reported in a domestic shorthaired cat with chronic nonregenerative anemia and probable myelodysplasia 17 .…”

Section: Figuresupporting

confidence: 63%

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Epidural myelolipoma in a Silken Windhound

Ierardi

Anderson

Bryan

et al. 2022

Veterinary Clinical Pathol

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A 12-year-old female spayed, Silken Windhound dog was presented with a 3-month history of lethargy and cervical and lumbosacral spinal pain. No significant abnormalities were noted on CBC or serum biochemical assays. Magnetic resonance imaging of the spine demonstrated a soft tissue mass within the ventral and right epidural space at the level of the L7 vertebra. During surgery, a pale brown mass was identified within the epidural fat. Cytologic and histopathologic examinations demonstrated that the mass was composed of adipose tissue and hematopoietic elements, consistent with a myelolipoma. The lumbosacral spinal pain resolved after surgery. Epidural myelolipomas are rarely reported in the human and veterinary literature.

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supporting

confidence: 86%

Section: Figuresupporting

confidence: 63%

Epidural myelolipoma in a Silken Windhound

Ierardi

Anderson

Bryan

et al. 2022

Veterinary Clinical Pathol

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“…The noncancerous proliferation of hematopoietic tissue outside the bone marrow causes expansion into nearby normal tissues. Paraspinal EMH affects 11–15% of thalassemic patients and is usually asymptomatic in the majority of them [2].…”

Section: Introductionmentioning

confidence: 99%

Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic Patient

Ismail

Massoud

Alexander

et al. 2019

Case Reports in Neurological Medicine

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Background Extramedullary hematopoiesis (EMH) is one of the rare causes of spinal cord compression (SCC). It results from noncancerous proliferation of hematopoietic tissue outside the bone marrow as a compensatory mechanism for ineffective erythropoiesis. It occurs in the paraspinal area in 11–15% of thalassemic patients in intermediate and severe cases causing a paraspinal compressive mass. We present a rare case of spinal EMH with thoracic cord compression in a 22-year-old female with beta thalassemia who presented with paraparesis and we provide a review of literature. Case Report A 22-year-old female patient with a known history of beta thalassemia presented with subacute onset of weakness and numbness of both lower limbs with a sensory level at T6. Magnetic resonance imaging (MRI) of the dorsal spine showed cord compression secondary to paraspinal EMH from T2 to T9 with most prominent compression over T5. She was managed with blood transfusion and low-dose radiotherapy. Conclusion Although rare, EMH should be suspected in thalassemic patients presenting with paraplegia. Treatment with blood transfusions is usually effective. Other options include radiotherapy, surgery, hydroxyurea or a combination of these modalities.

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“…In the rare entity of epidural extra-medullary hematopoiesis, the diffuse signal intensities of the vertebral bone marrow, presence of paravertebral soft-tissue component and homogenous pattern of enhancement in a patient with chronic anaemic state will provide clues in the differential diagnosis [11].…”

Section: Discussionmentioning

confidence: 99%

Idiopathic Late Subacute Epidural Hematoma: An Uncommon Cause of Pure Lumbar Radiculopathy with MR of Spinal Epidural Lesions Differentials; Revisited

Nouh¹,

Elshimy²,

Sakr³

et al. 2015

OMICS J Radiol

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Spontaneous spinal epidural hematoma is an increasingly recognized entity in clinical practice. MR is a valuable tool in diagnosis yet its chronological signal changes and different pattern of enhancement may impose a diagnostic difficulty. Other worrisome differential diagnostics with different management, prognoses represent the daily radiologist challenge. We present a case of pure lumbar radiculopathy caused by accidentally discovered spontaneous late sub-acute epidural hematoma and discuss the diagnostic differentials of lumbar spinal epidural mass lesions.

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Progressive Spinal Cord Compression Due to Epidural Extramedullary Hematopoiesis in Thalassemia Intermedia

Cited by 16 publications

References 38 publications

Epidural myelolipoma in a Silken Windhound

Epidural myelolipoma in a Silken Windhound

Compressive Dorsal Myelopathy Secondary to Extramedullary Hematopoiesis in a Thalassemic Patient

Idiopathic Late Subacute Epidural Hematoma: An Uncommon Cause of Pure Lumbar Radiculopathy with MR of Spinal Epidural Lesions Differentials; Revisited

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