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【Case Introduction】
38 years old, blood cachexia
Lateral x-ray of the chest
What is the most likely diagnosis?
1.
2.
3.
4.
5.
【Answer】
3.
【Discussion】
Extramedullary hematopoiesis of thalassemia
【Overview】
1.
2.
3.
4.
5.
6.
【Clinical symptoms】
1.
2.
【Imaging Performance】
1.
2.
Chest mass is usually seen in patients with thalassemia or congenital hemolytic anemia
3.
Enlargement of the bone marrow cavity and enlargement of the ribs are the most significant bone imaging manifestations
4.
The absorption of trabecular bones causes the thickening of bone shape
5.
Splenomegaly (or spleen deficiency)
6.
The lump is not calcified and usually does not cause bone erosion
7.
The lesion is often low density in CT scanning, and it can be slightly strengthened after enhancement
【Differential diagnosis】
Neurofibromatosis
【Treatment】
1.
Blood transfusion
2.
It has been reported that hydroxyurea can shrink the lump
【Complications】
1.
Compression of the spinal cord
2.
Pleural effusion
3.
Hemothorax
4.
Respiratory failure
Extramedullary hematopoiesis: left: large adjacent mass (white arrow) with smooth lobulated margins
.
All ribs (red arrows) enlarge, density consistency increases
.
Right: Larger paraspinal mass (white arrow)
visible.
