title: Thoracic Extramedullary Hematopoiesis Mimicking Metastatic Cancer.
abstract: Thoracic extramedullary hematopoiesis (EMH) is a rare manifestation in patients with myeloproliferative neoplasm. A 76-year-old woman with a long-standing history of polycythemia vera presented with a 2-month history of worsening dyspnea and left-sided wheezing. A chest computed tomography showed an ill-defined soft tissue mass encasing the left mainstem bronchus causing airway obstruction, associated with paratracheal and paraesophageal lymphadenopathy. Endobronchial ultrasound-guided fine needle aspiration of the soft tissue mass and mediastinoscopy with excisional biopsy of a paratracheal lymph node demonstrated EMH with increased myeloid blasts. A bone marrow biopsy confirmed postpolycythemic myelofibrosis consistent with progression of polycythemia vera to myelofibrosis. We describe the bronchoscopic management of a case of EMH presenting as a mediastinal mass, mimicking malignancy.
authors.affiliation: *Division of Pulmonary, Critical Care, and Sleep Medicine †Department of Pathology ‡Division of Hematology-Oncology, University of California San Diego, La Jolla, CA.
authors.forename: Duc
authors.initials: D
authors.lastname: Ha
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Liao
authors.forename: Huan-You
authors.initials: HY
authors.lastname: Wang
authors.forename: Catriona
authors.initials: C
authors.lastname: Jamieson
authors.forename: Marisa
authors.initials: M
authors.lastname: Magaña
authors.forename: Samir
authors.initials: S
authors.lastname: Makani
mesh_terms: D000368:Aged; D000402:Airway Obstruction / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001980:Bronchi / Q000000981:diagnostic imaging; D001999:Bronchoscopy / Q000379:methods; D003937:Diagnosis, Differential; D005260:Female; D006411:Hematopoiesis, Extramedullary; D006801:Humans; D016609:Neoplasms, Second Primary; D011087:Polycythemia Vera / Q000150:complications* / Q000000981:diagnostic imaging; D055728:Primary Myelofibrosis / Q000150:complications* / Q000000981:diagnostic imaging; D015607:Stents; D014057:Tomography, X-Ray Computed