A Rare Presentation of Extramedullary Hematopoiesis: Perirenal Masses

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Durmaz S., Sahin C., Basak M., Erturk Ş. M.

Journal of the College of Physicians and Surgeons Pakistan, cilt.32, sa.6, 2022 (SCI-Expanded) identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 32 Sayı: 6
  • Basım Tarihi: 2022
  • Doi Numarası: 10.29271/jcpsp.2022.supp1.s28
  • Dergi Adı: Journal of the College of Physicians and Surgeons Pakistan
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CAB Abstracts, EMBASE, MEDLINE, Veterinary Science Database
  • Anahtar Kelimeler: Computed tomography, Extramedullary hematopoiesis, Kidney, Magnetic resonance imaging
  • İstanbul Üniversitesi Adresli: Evet

Özet

© 2022 College of Physicians and Surgeons Pakistan. All rights reserved.Extramedullary hematopoiesis (EMH) is a physiological compensatory mechanism that develops in response to ineffective or insufficient hematopoiesis. Although the liver and spleen are the most common sites, EMH may occur anywhere in the body. Peri-renal involvement in EMH is quite rare and mimics tumoral lesions. To our knowledge, 12 peri-renal EMH cases have been reported in the literature so far. A 57-year woman was admitted to our hospital with non-specific abdominal pain. She had a history of chronic renal failure. On physical examination, diffuse abdominal tenderness and mild rigidity were detected. Blood tests revealed bicytopenia and elevated acute phase reactants. On non-contrast abdominal computed tomography (CT) scan, two peri-renal mass lesions of 4.5 cm and 4 cm were detected incidentally on the right side. Tumoral lesions were considered in the differential diagnosis, and magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET-CT) were performed. Lesions showed mild hypermetabolic activity (SUVmax: 4,68) on PET-CT images. For the definitive diagnosis, an ultrasound-guided core needle biopsy was performed. The histopathological examination was consistent with EMH. This case aims to highlight the peri-renal involvement of EMH, which mimics renal and peri-renal malignancies.