Intra-thoracic Extra-medullary Hematopoiesis-A Case Report

胸腔內的髓外造血－病例報告

黃仁慶(Lin-Keng Ng) ； 黃吉志(Jhi-Jhu Hwang) ； 王東衡(Tung-Heng Wang) ； 康婉儀(Wan-Yi Kang) ； 黃明賢(Ming-Shyan Huang)

《胸腔醫學》 21卷2期 (2006/04) Pp. 210-217

https://doi.org/10.29806/TM.200604.0011

摘要

胸腔內的髓外造血是一種罕見的縱隔腔腫瘤疾病。它通常無明顯症狀且生長非常緩慢，因此一般不需外科治療。在此我們提出一名以長期貧血而沒有接受輸血治療的球狀紅血球症的病例，在其胸腔內發現多個腫瘤經由超音波引導的切片檢查顯示三線的造血生成，符合髓外造血的診斷。此病例報告顯示一罕見的後縱膈腔腫瘤的診斷。因此，對於慢性貧血的患者，若發現無症狀的胸腔內腫瘤，髓外造血為必要的鑑別診斷之一以避免不必要的侵犯性檢查及治療。對於肋膜或肺部的髓外造血所引起的症狀，放射治療為一可考慮的治療方式。

關鍵字

髓外造血 ； 胸腔內腫瘤

並列摘要

Intra-thoracic extra-medullary hematopoiesis (EMH) is a rare disease in the differential diagnosis of mediastinal masses. It is usually asymptomatic, and since masses tend to be slow-growing, patients should not be subjected to unnecessary surgical interventions. We present a case of spherocytosis with long-term anemia without blood transfusion. Multiple intra-thoracic tumors were noted and echo-guided biopsy revealed tri-lineage hematopoiesis, which was compatible with EMH. This case report serves to remind us of an unusual diagnosis for posterior mediastinal masses. Hence, EMH should be considered in the differential diagnosis of patients who have chronic anemia with asymptomatic intra-thoracic tumors, and care should be taken to prevent further aggressive diagnostic and therapeutic measures. Low-dose radiation can be considered for the palliative treatment of pleural and pulmonary EMH.

並列關鍵字

extra-medullary hematopoiesis ； intra-thoracic tumor