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Case Reports
. 2023 Apr 27;18(7):2325-2328.
doi: 10.1016/j.radcr.2023.02.026. eCollection 2023 Jul.

Extramedullary hematopoiesis (EMH) in the liver allograft presenting with a mass-like lesion

Faeze Salahshour  1 , Ghazale Tefagh  1 , Masoume Safaei  2 , Farid Azmoudeh Ardalan  2 , Niloofar Ayoobi Yazdi  1 , Nahid Sedighi  1
Affiliations
Case Reports

Extramedullary hematopoiesis (EMH) in the liver allograft presenting with a mass-like lesion

Faeze Salahshour et al. Radiol Case Rep. .

Abstract

This is a rare case of extramedullary hematopoiesis (EMH) presenting as a mass-like lesion in liver allograft. Our patient was a 57-year-old woman who had undergone liver transplantation due to hepatic epithelioid hemangioendothelioma. She presented with an ill-defined hypoechoic lesion on ultrasound which showed features of focal EMH on pathologic examinations. While transient intrahepatic hematopoiesis has been reported in liver transplant patients, focal EMH mass lesion is a rarely encountered phenomenon. Therefore, focal EMH may need to be considered as a differential diagnosis when encountering a mass in post liver transplant patients.

Keywords: Extramedullary hematopoiesis (EMH); Hepatobiliary imaging; Hepatobiliary pathology; Liver transplant.

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Figures

Fig 1
Fig. 1
Hepatic CT shows an ill-defined lesion which is hyperdense to surrounding low-density fatty liver on noncontrast images (A). Contrast enhanced images show enhancement in arterioportal phase (B) with preserved enhancement in delayed phase (C).
Fig 2
Fig. 2
Hepatic MRI shows the lesion in right lobe. Note minimal high signal on T2-weighted images (A) and iso intensity on in phase T1 (B). On opposed phase T1 images (C), the lesion out stands with diffuse signal drop surrounding liver parenchyma due to steatosis. Also note enhancement pattern in early arterial phase (D), portal (E), and delayed (F) phase.
Fig 3
Fig. 3
Liver tissue with focal extramedullary hematopoiesis. The red arrow shows a megakaryocyte surrounded by mixed myeloid and lymphoid cells. Scattered hepatocytes with fatty change (macrovesicular type) are also noted (blue arrows). H&E. ×100.
See this image and copyright information in PMC

References

    1. Golub R, Cumano A. Embryonic hematopoiesis. Blood Cells Mol Dis J. 2013;51(4):226–231. - PubMed
    1. Wong Y, Chen F, Tai K, Yip L, Tsang K, Chan F, et al. Imaging features of focal intrahepatic extramedullary haematopoiesis. Brit J Radiol. 1999;72(861):906–910. - PubMed
    1. Tsamandas AC, Jain AB, Raikow RB, Demetris AJ, Nalesnik MA, Randhawa PS. Extramedullary hematopoiesis in the allograft liver. Mod Pathol J. 1995;8(6):671–674. - PubMed
    1. Schlitt HJ, Schäfers S, Deiwick A, Eckardt KU, Pietsch T, Ebell W, et al. Extramedullary erythropoiesis in human liver grafts. Hepatol J. 1995;21(3):689–696. - PubMed
    1. Fan N, Lavu S, Hanson CA, Tefferi A. Extramedullary hematopoiesis in the absence of myeloproliferative neoplasm: Mayo Clinic case series of 309 patients. Blood Cancer J. 2018;8(12):1–4. - PMC - PubMed

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