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  • Title: Presacral extramedullary hematopoiesis: a diagnostic confusion concerning a rare presentation.
    Author: Al-Aabassi A, Murad BA.
    Journal: Med Princ Pract; 2005; 14(5):358-62. PubMed ID: 16103704.
    Abstract:
    OBJECTIVE: To report a rare case of extramedullary hematopoiesis (EMH) with an asymptomatic intrapelvic mass in a patient with thalassemia major. CLINICAL PRESENTATION: The patient presented with a pelvic mass discovered by ultrasonography before undertaking laparoscopic cholecystectomy for gallstones. Technetium-99m MDP bone scan failed to differentiate EMH from malignancy. A fine-needle aspiration smear was misdiagnosed when atypical megakaryocytes were interpreted as malignant cells. EMH was suggested by magnetic resonance imaging and confirmed by an ultrasound-guided Tru-Cut biopsy. CONCLUSION: This case report illustrates the need to consider EMH in the differential diagnosis of patients with chronic hematological disorders and mass lesions in extramedullary sites.
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