Andrew S. Roberts MD, Presenter: Nothing to Disclose

Anup Shashindra Shetty MD, Abstract Co-Author: Nothing to Disclose

Vincent M. Mellnick MD, Abstract Co-Author: Nothing to Disclose

Perry J. Pickhardt MD, Abstract Co-Author: Co-founder, VirtuoCTC, LLC Stockholder, Cellectar Biosciences, Inc

Sanjeev Bhalla MD, Abstract Co-Author: Nothing to Disclose

Christine O. Menias MD, Abstract Co-Author: Nothing to Disclose

-Hematopoiesis occurs in the bone marrow of the medullary cavity in long bones, vertebral bodies, and ribs of adults -In the fetus, hematopoiesis occurs in the liver, spleen, and bone marrow -Lack of appropriate hematopoiesis at normal sites can be caused by marrow-replacing processes, such as leukemia and myelofibrosis, and blood disorders, including sickle cell anemia and thalassemia -The body responds by creating sites of extramedullary hematopoiesis (EMH) -Typical manifestations of EMH include hepatosplenomegaly and soft tissue attenuation masses in the paraspinal region which can mimic metastasis, sarcoma, neurofibroma, and lymphadenopathy -Less common presentations include pulmonary interstitial infiltrates, rib expansions, and soft tissue masses outside of the paraspinal region -EMH frequently occurs in more than location, rather than in isolation -When a soft tissue mass in a typical location for EMH is encountered, clinical history is crucial for suggesting this diagnosis -Biopsy is often required for definitive diagnosis, particularly for masses outside the paraspinal region  

Epidemiology and Pathophysiology of EMH Cases of typical presentations of EMH in the chest, abdomen and pelvis Atypical presentations of EMH Mimics and differential diagnosis of EMH Biopsy considerations  

http://abstract.rsna.org/uploads/2014/14004063/14004063_wju1.pdf

Roberts, A, Shetty, A, Mellnick, V, Pickhardt, P, Bhalla, S, Menias, C, Thinking Outside the Bone: A Pictorial Review of Extramedullary Hematopoiesis.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14004063.html