Unilateral cerebellar hypoplasia
Heather Borders, MD
over 7 years ago
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Joseph Junewick, MD FACR
|Diagnostic Category: Neoplasia Malignant
|Created: over 5 years ago
|Updated: over 5 years ago
Nearly 2 year old male with abdominal pain and fever.
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.