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Extramedullary Hematopoiesis Presented as a Posterior Mediastinal Mass in a Woman with Thalassemia Intermedia

中度地中海型貧血婦女後縱膈腔腫塊的髓外造血

摘要


本文內容主述一名患有乙型地中海型貧血婦人,30年前曾切除脾臟,目前主述呼吸急促且有日益劇增的情況。經胸部電腦斷層掃描和磁振造影之成像結果顯示於縱膈後下方處有一顆3×3公分的腫塊,懷疑是髓外造血所引起。經核醫鎵-67腫瘤檢查顯示並無腫塊的異常攝取。此外;鎝-99m骨髓造影檢查則顯示在右後下中膈,且鄰近胸椎的位置,有一個局部熱區位置,認為此腫塊為髓外造血。因髓外造血組織若經穿刺切片後,病人可能有高出血的風險,經核醫非侵入性的造影診斷結果,可使病人獲得適當的治療及處置。

並列摘要


We described the case of a thalassemic woman who underwent splenectomy three decades ago, and complained of shortness of breath that progressively worsened. Chest computed tomography and magnetic resonance imaging revealed a 3×3 cm mass over the posteroinferior mediastinum, and the mass was suspected to be extramedullary hematopoiesis (EMH). A Gallium-67 tumor survey showed no abnormal uptake over this mass. Tc-99m sulfur colloid bone marrow scintigraphy revealed a focal hot area in the right posteroinferior mediastinum adjacent to the T-spine, suggesting EMH. According to the diagnosis of noninvasive radionuclide scanning, the patient underwent a suitable management without taking the risk of a biopsy.

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