Presacral extramedullary hematopoiesis: a diagnostic confusion concerning a rare presentation.
OBJECTIVE
To report a rare case of extramedullary hematopoiesis (EMH) with an asymptomatic intrapelvic mass in a patient with thalassemia major.


METHODS
The patient presented with a pelvic mass discovered by ultrasonography before undertaking laparoscopic cholecystectomy for gallstones. Technetium-99m MDP bone scan failed to differentiate EMH from malignancy. A fine-needle aspiration smear was misdiagnosed when atypical megakaryocytes were interpreted as malignant cells. EMH was suggested by magnetic resonance imaging and confirmed by an ultrasound-guided Tru-Cut biopsy.


CONCLUSIONS
This case report illustrates the need to consider EMH in the differential diagnosis of patients with chronic hematological disorders and mass lesions in extramedullary sites.
Al-Aabassi
Abdulla
A
Department of General Surgery, Saqr Hospital, Ras Alkhaimah, United Arab Emirates. albassi@hotmail.com
Murad
Basil A
BA
D000222:Adaptation, Physiological; D000328:Adult; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D008279:Magnetic Resonance Imaging; D010386:Pelvic Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000503:physiopathology; D010388:Pelvis / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography; D014479:United Arab Emirates; D017086:beta-Thalassemia / Q000503:physiopathology