Cortical bone invasion in non-transfusion-dependent thalassemia: tumefactive extramedullary hematopoiesis reviewed

Karim Z Masrouha; Joelle Wazen; Anthony Haddad; Fadi Saadeh; Ali Taher; Nabil J Khoury

doi:10.1007/s11547-016-0638-1

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Cortical bone invasion in non-transfusion-dependent thalassemia: tumefactive extramedullary hematopoiesis reviewed

Journal article

Peer reviewed

Cortical bone invasion in non-transfusion-dependent thalassemia: tumefactive extramedullary hematopoiesis reviewed

Karim Z Masrouha, Joelle Wazen, Anthony Haddad, Fadi Saadeh, Ali Taher and Nabil J Khoury

Radiologia medica, Vol.121(8), pp.626-634

08/01/2016

DOI: 10.1007/s11547-016-0638-1

PMID: 27108419

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Abstract

To assess the prevalence of cortical bone invasion (CBI) with secondary extramedullary hematopoiesis (EMH) in patients with non-transfusion-dependent thalassemia (NTDT), to determine its predilection sites on thoracic and abdominal imaging, to determine whether there is an association between various clinical and hematological parameters, and to evaluate its various findings mainly on magnetic resonance imaging (MRI), in addition to computed tomography (CT) scans. This is a retrospective cohort study of 57 patients with NTDT imaged by CT or MRI. Both clinical and laboratory data were gathered. An imaging scoring system was used to describe the appearance of CBI by MRI. Twenty-seven patients (47.4 %) were found to have CBI and EMH with the most common location being the thoracic spine. Splenectomy and lower hemoglobin level were found to be independent risk factors for its development. Most lesions were homogenous (70 %), had predominant red marrow signal (67 %), and well-defined margins (89 %). CBI and secondary tumefactive EMH are common findings in patients with NTDT, with distinct imaging and clinical characteristics. An increased risk was seen in patients with splenectomy and lower hemoglobin. The imaging scoring system described is helpful in diagnosing and describing this entity, hence precluding unnecessary biopsies.

Adolescent

Adult

Child

Contrast Media

Cortical Bone - diagnostic imaging

Cortical Bone - pathology

Female

Hematopoiesis, Extramedullary

Humans

Iohexol

Magnetic Resonance Imaging

Male

Middle Aged

Retrospective Studies

Risk Factors

Thalassemia - complications

Tomography, X-Ray Computed

Details

Title: Subtitle: Cortical bone invasion in non-transfusion-dependent thalassemia: tumefactive extramedullary hematopoiesis reviewed
Creators: Karim Z Masrouha - American University of Beirut Medical Center
Joelle Wazen - American University of Beirut Medical Center
Anthony Haddad - American University of Beirut Medical Center
Fadi Saadeh - American University of Beirut
Ali Taher - American University of Beirut Medical Center
Nabil J Khoury - American University of Beirut Medical Center
Resource Type: Journal article
Publication Details: Radiologia medica, Vol.121(8), pp.626-634
DOI: 10.1007/s11547-016-0638-1
PMID: 27108419
ISSN: 0033-8362
eISSN: 1826-6983
Language: English
Date published: 08/01/2016
Academic Unit: Radiology
Record Identifier: 9984697728702771

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