Extramedullary haematopoiesis

(EMH)
is the formation of mature red blood cells outside
Fig.1. Lateral skull x-rays . The radiographs demonstrate the "hair on
end" striations in keeping with expansion of the intramedullary bone
marrow (arrowed).
Fig.2. Plain radiograph of bilateral established periosteal reaction
(blue arrows) and soft tissue swelling overlying the tibial shin
anteriorly with some new bone formation over the right proximal tibial
diaphysis anteriorly.
Fig.3-4. STIR coronal and post contrast axial MR images. There is a
symmetrical soft tissue component laterally on both sides (blue
arrows), which enhances slightly with contrast (pink arrows).
Fig.5-6. Frontal chest radiograph and axial CT thorax image with IV
contrast. There was an incidental finding of a soft tissue density mass
adjacent to right heart border.
Fig.7. the axial CT abdomen images. There is a small solitary low
attenuation
Fig. 4
1
2
3 Fig. 8
5
7
6
lesion (pink arrow) within the spleen. This is a case of extramedullary
haematopoeisis .
Fig.8. CECT abdomen showed mass measuring 6.5 5 3.5 cm
noted in lower pole of right kidney with mild homogenous contrast

By Bolatov Aidos, 339-GM

enhancement

Thorax Abdomen
Lateral skull x-rays of a 2
year old child who
presented with frontal
bossing. The radiographs
demonstrate the "hair on
end" striations in keeping
with expansion of the
intramedullary bone
marrow (arrowed). Note
there is sparing of the
occipital bone. After further
investigations, this patient
was diagnosed with
thalassaemia.
The plain radiograph of both
lower limbs in a paediatric
patient with known sickle cell
anaemia presenting with
bilateral lower limb pain. There
is bilateral established
periosteal reaction (blue
arrows) and soft tissue swelling
overlying the tibial shin
anteriorly with some new bone
formation over the right
proximal tibial diaphysis
anteriorly.
STIR coronal and post contrast axial
MR images from the same patient
demonstrating high signal within the
medulla of both tibia, more so on the
left, and fluid within the anterior
fascial planes.
There is a symmetrical soft tissue
component laterally on both sides
(blue arrows), which enhances
slightly with contrast (pink arrows).
The differentials for these findings
included infection and extramedullary
haematopoeisis. After further
investigations, the latter was found to
Above are the frontal chest radiograph
and axial CT thorax image with IV
contrast, from a patient presenting with
respiratory distress. There was an
incidental finding of a soft tissue
density mass adjacent to right heart
border on the chest radiograph (pink
arrow,The CT demonstrated a right
paravertebral mass consisting of both
Above are the axial CT abdomen
images of an adult patient in the
portal venous phase demonstrating
splenomegaly. There is a small
solitary low attenuation lesion (pink
arrow) within the spleen. This is a
case of extramedullary
CECT abdomen showed mass
measuring 6.5 5 3.5 cm noted in
lower pole of right kidney with mild
homogenous contrast enhancement
 References
Extra-medullary haematopoiesis: a pictorial
review of its typical and atypical locations in
our practice. A. Sahu, F. Wotton, S. Chhatani,
M. Williams. DOI: 10.1594/ecr2014/C-1454.
European Society of Radiology.
Extramedullary hematopoiesis presenting as a
solitary renal mass and mimicking a malignant
tumor: A rare case report. Basharat
Mubeen,Iqbal M Lone,Arif Hameed,Annu
Charak,Imza Feroz. DOI:10.4103/2321-
4848.123035. AM&HS.