Thoracic Extramedullary Hematopoiesis Mimicking Metastatic Cancer. Issue 4 (October 2016)

• Record Type: Journal Article
• Authors: Ha, Duc; Liao, Xiaoyan; Wang, Huan-You; Jamieson, Catriona; Magaña, Marisa; Makani, Samir
• Is Part Of: Journal of bronchology & interventional pulmonology. Volume 23:Issue 4(2016)
• Publication Date: 2016-10
• Subjects: extramedullary hematopoiesis -- polycythemia vera -- mediastinal mass -- bronchial -- obstruction -- cancer; Bronchoscopy -- Periodicals; Lungs -- Diseases -- Periodicals; Respiratory Tract Diseases -- Periodicals; Lung Diseases -- surgery -- Periodicals; Diagnostic Techniques, Respiratory System -- Periodicals; Bronchi; Bronchoscopy; Lungs -- Diseases; Periodicals; 616.23
• DOI: 10.1097/LBR.0000000000000296
• Languages: English
• ISSNs: 1944-6586

Abstract

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.