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Scintigraphic Diagnosis of Intrathoracic Extramedullary Hematopoiesis in Alcohol-Related Macrocytosis

Departments of Nuclear Medicine and Pneumology, Saint John 's General Hospital, Brugge, Belgium

Correspondence: For correspondence or reprints contact: Frank De Geeter, MD, Department of Nuclear Medicine, Algemeen Ziekenhuis Sint-Jan, Ruddershove 10, 8000 Brugge, Belgium.

ABSTRACT

We report the scintigraphic diagnosis of thoracic extramedullary hematopoiesis in a case of alcohol-related macrocytosis. A patient with liver cirrhosis and alcohol-related macrocytosis showed multiple rounded masses in the low thoracic paraspinal region on chest radiography and CT. Whole-body scintigraphy and SPECT imaging of the thorax, after nanocolloid administration, demonstrated expansion of the bone marrow in the humeri and femora and uptake of the tracer in the mediastinal masses, establishing the diagnosis of mediastinal extramedullary hematopoiesis. Thoracic extramedullary hematopoiesis may occur in conjunction with alcohol-related macrocytosis. Scintigraphy with ^99mTc-nanocolloids is a suitable noninvasive method to establish the presence of extramedullary marrow.

Key Words: technetium-99m-colloid • bone marrow scintigraphy • extramedullary hematopoiesis • posterior mediastinal tumor • macro cytosis

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