Extramedullary haemopoiesis and spinal cord compression.

摘要

A 35-year-old man presented with acute paraplegia. He had a past history of major thalassaemia beta-delta, which was refractory to previous treatment, including splenectomy. Transfusions had failed to adequately increase his haemoglobin concentrations, because of auto-immunisation against Kpb antigen, and he had extramedullary haemopoiesis. Chest radiography (figure A) showed rib enlargement due to bone marrow hypertrophy, and extra-pleural abnormalities. A chest CT showed numerous soft-tissue masses (figure B) with ectopic foci of haemopoiesis and pleural effusions. An MRI of our patient's spine showed a lobulated mass (figure C) which protruded into the spinal canal and compressed the spinal cord at T7-T10. Our patient had surgical decompression to remove the lesion; histology (figure D) showed extensive extramedullary haemopoiesis with strong erythroid hyperplasia. A left shift with an increased number of blasts was also seen on histology. After surgery our patient recovered well, and was able to walk.