Paraspinal Extramedullary Hematopoiesis Diagnosed Using Tc-99m Sulfur Colloid

摘要

A 73-year-old man with thalassemia intermedia presented acutely with abdominal pain and distension. He had previously undergone a splenectomy. A diagnostic computed tomography (CT) scan through the abdomen and pelvis was performed with oral and intravenous contrast. This showed bilateral paravertebral and retrocrural soft tissue masses. It was believed that this was unlikely to be the cause of the patient's acute presentation. Nevertheless, the possibility of lymphoma or extramedullary hematopoiesis was raised. To avoid an invasive diagnostic biopsy, a Tc-99m sulfur colloid scan was performed. Initially, planar images were obtained; however, no clear corresponding colloid uptake was demonstrated. Therefore, a single-photon computed emission tomography (SPECT)/CT examination was performed. This demonstrated uptake of Tc-99m sulfur colloid in the paravertebral masses, confirming that these are likely to represent extramedullary hematopoiesis rather than lymphoma.