Extramedullary hematopoiesis involving uterus, fallopian tubes, and ovaries, mimicking bilateral tuboovarian abscesses. Int J Gynecol Pathol 2012 Nov;31(6):584-7
Date
09/29/2012Pubmed ID
23018220DOI
10.1097/PGP.0b013e31825183adScopus ID
2-s2.0-84867404380 (requires institutional sign-in at Scopus site) 8 CitationsAbstract
Extramedullary hematopoiesis (EMH) is normal during fetal life, but after birth, the presence of EMH is considered to be abnormal. The most common sites for EMH are the liver, the spleen, and paraspinal regions of the thorax; however, it has been reported to involve virtually any organ or tissue. To our knowledge, this is the first reported case of EMH involving the entire upper genital tract, including the uterus, fallopian tubes, and ovaries. A 43-yr-old African American woman presented with a tender pelvic mass and a markedly elevated white blood cell count. Imaging was consistent with bilateral tuboovarian abscesses. Laparotomy and removal of uterus, tubes, and ovaries and bone marrow biopsy confirmed chronic myelogenous leukemia in the chronic phase and EMH in the cervix, endometrium, and ovaries, and no evidence of infection. We believe this to be the first reported case of EMH involving all organs of the upper genital tract presenting in a patient who has chronic myelogenous leukemia but not in blast crisis. This case illustrates the importance of a broad differential diagnosis when managing a patient with a pelvic mass and the value of a multidisciplinary team approach.
Author List
Palatnik A, Narayan R, Walters MAuthors
Raj Narayan MD Associate Dean, Professor in the Obstetrics and Gynecology department at Medical College of WisconsinAnna Palatnik MD Associate Professor in the Obstetrics and Gynecology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AbscessAdult
Diagnosis, Differential
Fallopian Tube Diseases
Fallopian Tubes
Female
Hematopoiesis, Extramedullary
Humans
Ovarian Diseases
Ovary
Uterus