CTICasesPulmonary Extramedullary Hematopoiesis in Myelofibrosis
Imaging findings
Serial chest CTs over several months in a patient with known myelofibrosis show diffuse, bilateral ground-glass opacity throughout the lungs without airway wall thickening or other findings to suggest an infectious or inflammatory airway process, with the pattern essentially unchanged across multiple follow-up studies. PET imaging shows diffuse pulmonary FDG uptake corresponding to the ground-glass opacity as well as marrow uptake at other sites.
Key takeaways
The combination of unchanging diffuse ground-glass opacity and diffuse pulmonary FDG avidity in a patient with myelofibrosis is characteristic of pulmonary extramedullary hematopoiesis, a rare but well-described manifestation in which hematopoietic cells accumulate within the pulmonary interstitium. The patient also has pulmonary hypertension attributed to the underlying hematologic disorder, classified as Group 5 pulmonary hypertension, rather than left heart disease, and biopsy was not felt to be necessary given the characteristic imaging and PET findings.
AI-assisted summary — may contain errors. Verify against the source video. Learn more
More from this webinar
- Slow-Flow Mixing Artifact (Pseudo-Thrombus) in the Aorta and Left Atrial AppendageArtifact
- Behcet Syndrome with Right Ventricular Thrombus and Pulmonary InfarctionAutoimmune
- Diaphragmatic Hernia from Remote Chest Tube PlacementIatrogenic
- Virchow Node Metastasis from Peritoneal Serous CarcinomaNeoplastic
- Lower Lobe-Predominant Bronchiectasis from Vertically Acquired HIV InfectionInfection
- Prominent Pericardial Recess Mimicking Mediastinal LymphadenopathyArtifact
- Mixed-Dust Pneumoconiosis Nodules Mimicking Pulmonary MetastasesExposure
- Patent Ductus Arteriosus Communicating with the False Lumen in a Type B Aortic DissectionCongenital
See all cases from May 17, 2018 →
Related Metabolic cases
- Solitary Pulmonary Amyloidoma
- Brown Tumors from Renal Osteodystrophy (Secondary Hyperparathyroidism)
- Caseous (Milk of Calcium) Calcification of the Mitral Annulus
- Metastatic Pulmonary Calcification in End-Stage Renal Disease
- Metastatic Pulmonary Calcification Demonstrating a Rosette Pattern
- Isolated Pericardial Amyloidosis