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Joseph Junewick, MD FACR
over 4 years ago
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Extramedullary Hematopoiesis

Case Detail

Anatomy: Gastrointestinal
Joseph Junewick, MD FACR
Diagnostic Category: Neoplasia Malignant
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: US CT
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Nearly 2 year old male with abdominal pain and fever.

Case Images


Extramedullary Hematopoiesis

Clinical Notes

Pathology – Extramedullary hematopoiesis secondary to acute T cell lymphoblastic leukemia.


US – Hepatosplenomegaly with microcystic appearance of the spleen, disordered hepatic echotexture and perihepatic adenopathy.

CT – Coronal reformat confirming US findings.


Extramedullary hematopoiesis is a mechanism to compensate for deficient red cell mass. It is known to occur with myleofibrosis, various anemias and chronic myelogenous leukemia but is rare in acute leukemias. Hepatosplenomegaly with a microcystic echotexture is typical of extramedullary hematopoiesis; infection (usually fungal microabscesses), lymphatic obstruction and lymphatic malformation, and leukemic infiltration could also be considered in the differential diagnosis.


Kopecky KK, Moriarty AT, Antony AC et al. Extramedullary Hematopoiesis in Acute Lymphocytic Leukemia Masquerading as Hepatic, Renal, and Splenic Microabscesses. AJR (1986); 147: 846-847.

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