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Case Reports
. 2017:2017:2416365.
doi: 10.1155/2017/2416365. Epub 2017 Jan 4.

Myelopathy due to Spinal Extramedullary Hematopoiesis in a Patient with Polycythemia Vera

Shuhei Ito  1 , Nobuyuki Fujita  1 , Naobumi Hosogane  2 , Narihito Nagoshi  1 , Mitsuru Yagi  1 , Akio Iwanami  1 , Kota Watanabe  1 , Takashi Tsuji  3 , Masaya Nakamura  1 , Morio Matsumoto  1 , Ken Ishii  1
Affiliations
Case Reports

Myelopathy due to Spinal Extramedullary Hematopoiesis in a Patient with Polycythemia Vera

Shuhei Ito et al. Case Rep Orthop. 2017.

Abstract

Extramedullary hematopoiesis (EMH) occasionally occurs in patients exhibiting hematological disorders with decreased hematopoietic efficacy. EMH is rarely observed in the spinal epidural space and patients are usually asymptomatic. In particular, in the patients with polycythemia vera, spinal cord compression due to EMH is extremely rare. We report a case of polycythemia vera, in which operative therapy proved to be an effective treatment for myelopathy caused by spinal EMH.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Preoperative MRI showed an epidural mass extending from the fifth to the tenth thoracic vertebra canal. (a) Sagittal plane. (b) Axial plane (Th7).
Figure 2
Figure 2
Photograph of the thoracic epidural mass. (a) The dorsal epidural mass is continuous from the fifth to the tenth thoracic vertebra canal after laminectomy. (b) The thoracic epidural mass specimen is reddish brown and hematoma like in appearance.
Figure 3
Figure 3
Histology of the epidural mass. Hematoxylin and eosin staining. Arrows suggest hematopoietic cells. Black, megakaryocytic; red, erythropoietic; yellow, myelopoietic. Magnification ×40.
Figure 4
Figure 4
Immunohistochemistry of the epidural mass. High expression of cell surface markers for erythroblasts (glycophorin A), megakaryocytes (CD41), and granulocytes (MPO) was observed. Magnification ×40.
Figure 5
Figure 5
MRI taken one year later shows no recurrence. (a) Sagittal plane. (b) Axial plane.
See this image and copyright information in PMC

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