Surgical resection of extramedullary haematopoiesis in the posterior mediastinum

Abstract

Extramedullary haematopoiesis is a rare disease that is usually associated with haematologic disorders such as thalassemia, myelodysplastic syndrome, and hereditary spherocytosis. It frequently occurs in the liver, spleen, and lymph nodes. Rarely, it occurs in the posterior mediastinum. We report the case of a 59‐year‐old man with lateral posterior mediastinal masses that were incidentally detected during treatment for hereditary spherocytosis. We performed video‐assisted thoracic surgery to confirm the diagnosis and differentiate the masses from neurogenic tumours and other posterior mediastinal diseases. The pathological findings were consistent with intrathoracic extramedullary haematopoiesis. Although extramedullary haematopoiesis can be managed without interventions, surgery may be required in some cases. In such cases, video‐assisted thoracoscopic surgery is advised because it is a useful and less invasive procedure.

Nonanemic extramedullary hematopoiesis in the posterior mediastinum

“…Its high vascularity results in enhancement on contrast CT. 3 EMH in the posterior mediastinum should be differentially diagnosed from tumors of neural origin, lymphoma, myelolipoma, liposarcoma, and metastases. 4 The diagnosis of EMH can be confirmed by pathological studies showing trilineage hematopoietic cells. The prognosis depends on its hematologic conditions and complications.…”

Kongenitale hämolytische Anämien durch Membran- und Enzymdefekte der Erythrozyten

“…Nicht splenektomierte Erwachsene entwickeln nicht selten mediastinale hämatopoetische Tumore (extramedulläre Blutbildung; Patienten ab 40 Jahren) [23] und Ulcera cruris (ältere Patienten) [24]. Auch ist in der Mehrzahl der Fälle im Erwachsenenalter eine Cholezystektomie erforderlich.…”