Extramedullary hematopoiesis manifesting as a symptomatic pleural effusion.
The occurrence of extramedullary hematopoiesis in the pleura is rare and is usually asymptomatic. It is generally diagnosed on postmortem examination. Herein we describe a 61-year-old woman with agnogenic myeloid metaplasia who sought medical assessment because of progressive dyspnea. Thoracentesis yielded sanguineous fluid with 10% myeloblasts. A 99mTc bone marrow scan demonstrated increased tracer activity throughout both lungs, an outcome consistent with extramedullary hematopoiesis. Fine-needle aspiration and video-assisted thoracoscopy were considered but deferred because of the potential risk of profuse bleeding. Treatment with low-dose external beam irradiation to the left posterior pleura was successful. To date, no hemothorax has recurred.
D005260:Female; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D008875:Middle Aged; D010994:Pleura / Q000502:physiology*; D010996:Pleural Effusion / Q000175:diagnosis / Q000209:etiology* / Q000532:radiotherapy; D055728:Primary Myelofibrosis / Q000150:complications*; D013671:Technetium Tc 99m Sulfur Colloid; D014057:Tomography, X-Ray Computed
D013671:Technetium Tc 99m Sulfur Colloid