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Georgakopoulou VE, Damaskos C, Mantzouranis K, Melemeni D, Gkoufa A, Chlapoutakis S, Garmpis N, Sklapani P, Aravantinou A, Garmpi A, Trakas N, Tsiafaki X. Invasive methods for the diagnosis and management of intrathoracic extramedullary hematopoiesis: A literature review. Respir Med Res 2021; 79:100815. [PMID: 33610912 DOI: 10.1016/j.resmer.2021.100815] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/29/2021] [Accepted: 01/31/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Extramedullary hematopoiesis is defined as hematopoiesis occurring outside of the bone marrow. It usually compensates insufficient bone marrow function or ineffective erythropoiesis and is observed mostly in hematological disorders. Most common locations of extramedullary hematopoiesis are the spleen, the liver and the lymph nodes. Intrathoracic extramedullary hematopoiesis is rare presenting as bilateral lobulated masses of lower paravertebral regions. This review summarizes the role of invasive techniques in the diagnosis and management of intrathoracic EMH and its complications. METHODS An electronic search in PubMed and Google Scholar was conducted with the keywords "intrathoracic extramedullary hematopoiesis" AND "surgery" OR "video-assisted thoracic surgery (VATS)" OR "medical thoracoscopy" OR "biopsy" OR "thoracotomy" OR "image-guided biopsy" OR "median sternotomy", within 1970 to 2020 with the limitation of English language to include those articles reporting data on invasive techniques in intrathoracic extramedullary hematopoiesis. RESULTS Overall, 93 articles were originally identified using our search criteria and from the reference list of the previously identified documents. Following elimination of duplicates, 29 were excluded after title, abstract or full text screening, since they did not report the use of invasive techniques in the diagnosis and management of intrathoracic extramedullary hematopoiesis. CONCLUSIONS Although in some cases radiological features are typical for the diagnosis of intrathoracic extramedullary hematopoeisis, invasive methods such as bronchoscopy with transbronchial biopsy, ιmage-guided fine needle aspiration, endobronchial ultrasound-guided fine needle aspiration of the mass and mediastinoscopy, medical thoracoscopy, median sternotomy, video-assisted thoracoscopic surgery and thoracotomy, are essential for definite diagnosis and management.
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Affiliation(s)
- V E Georgakopoulou
- Pulmonology Department, Laiko General Hospital, 17 Agiou Thoma Street, 11527, Athens, Greece.
| | - C Damaskos
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - K Mantzouranis
- 1st Pulmonology Department Sismanogleio Hospital, Athens, Greece
| | - D Melemeni
- 1st Pulmonology Department Sismanogleio Hospital, Athens, Greece
| | - A Gkoufa
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - S Chlapoutakis
- Department of Thoracic Surgery, Agios Savvas Hospital, Athens, Greece
| | - N Garmpis
- Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece; N.S. Christeas Laboratory of Experimental Surgery and Surgical Research, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - P Sklapani
- Department of Cytology, Mitera Hospital, Athens, Greece
| | - A Aravantinou
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - A Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - N Trakas
- Department of Biochemistry, Sismanogleio Hospital, Athens, Greece
| | - X Tsiafaki
- 1st Pulmonology Department Sismanogleio Hospital, Athens, Greece
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Révélation à l’âge adulte d’une sphérocytose héréditaire devant une tumeur rénale : forme frontière entre myélolipome et foyer d’hématopoïèse extra-médullaire. Rev Med Interne 2015; 36:848-53. [DOI: 10.1016/j.revmed.2015.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 01/18/2015] [Accepted: 02/18/2015] [Indexed: 11/21/2022]
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Keikhaei B, Zandian K, Rahim F. Existence of cord compression in extramedullary hematopoiesis due to beta thalassemia intermedia. Hematology 2008; 13:183-6. [PMID: 18702878 DOI: 10.1179/102453308x343347] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Extramedullary hematopoiesis (EMH) is a rare disorder, characterized by the appearance of hematopoietic elements outside of the bone marrow, which occurs in patients with chronic myeloproliferative disorders or congenital hemolytic anemias. We report a case with thalassemia intermedia, EMH in spinal cord and a paravertebral mass. We report the case of a 20 year old female who initially presented with back pain and leg weakness was found to have paravertebral mass in the spinal cord.
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Affiliation(s)
- Bijan Keikhaei
- Research Center of Thalassemia and Hemoglobinopathies (RCTH), Ahwaz Jondishapour University of Medical Sciences, Ahwaz, Iran.
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