title: [Spinal cord compression due to extramedullary hematopoiesis in a patient with myelofibrosis].
abstract: Development and growth of hematopoietic tissue outside of the bone marrow is termed extramedullary hematopoiesis (EMH). It occurs in patients with hematological diseases such as myelofibrosis and thalassemia. Liver and spleen are the usual sites of EMH. However, spinal cord compression caused by EMH is a rare complication. A 65-year-old man with myelofibrosis was admitted to our hospital with progressive paraparesis. Thoracic spine MRI revealed epidural masses causing cord compression. Histological examination of the epidural mass showed evidence of EMH consisting of megakaryocytic and erythroid hyperplasia. After surgical decompression and radiotherapy, lower limb weakness and sensory disturbance were significantly improved. MRI showed disappearance of the spinal cord compression. With this therapy, he had no recurrence until he died of myelofibrosis. Spinal EMH should be considered as a differential diagnosis in patients with hematological diseases presenting with paraparesis. Surgical decompression and radiotherapy are effective approaches for the treatment of paraparesis due to EMH.
authors.affiliation: Department of Neurology, Anjo Kosei Hospital.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hijikata
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ando
authors.forename: Tomonori
authors.initials: T
authors.lastname: Inagaki
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Watanabe
authors.forename: Mizuki
authors.initials: M
authors.lastname: Ito
authors.forename: Gen
authors.initials: G
authors.lastname: Sobue
mesh_terms: D000368:Aged; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D008297:Male; D055728:Primary Myelofibrosis / Q000503:physiopathology*; D013117:Spinal Cord Compression / Q000209:etiology* / Q000628:therapy