Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Spinal cord compression due to extramedullary hematopoiesis in a patient with myelofibrosis

Yasuhiro Hijikata, M.D.1)2), Tetsuo Ando, M.D.1), Tomonori Inagaki, M.D.1), Hirohisa Watanabe, M.D.2), Mizuki Ito, M.D.2) and Gen Sobue, M.D.2)

1)Department of Neurology, Anjo Kosei Hospital
2)Department of Neurology, Nagoya University Graduate School of Medicine

Development and growth of hematopoietic tissue outside of the bone marrow is termed extramedullary hematopoiesis (EMH). It occurs in patients with hematological diseases such as myelofibrosis and thalassemia. Liver and spleen are the usual sites of EMH. However, spinal cord compression caused by EMH is a rare complication. A 65-yearold man with myelofibrosis was admitted to our hospital with progressive paraparesis. Thoracic spine MRI revealed epidural masses causing cord compression. Histological examination of the epidural mass showed evidence of EMH consisting of megakaryocytic and erythroid hyperplasia. After surgical decompression and radiotherapy, lower limb weakness and sensory disturbance were significantly improved. MRI showed disappearance of the spinal cord compression. With this therapy, he had no recurrence until he died of myelofibrosis. Spinal EMH should be considered as a differential diagnosis in patients with hematological diseases presenting with paraparesis. Surgical decompression and radiotherapy are effective approaches for the treatment of paraparesis due to EMH.
Full Text of this Article in Japanese PDF (5691K)

(CLINICA NEUROL, 54: 27|31, 2014)
key words: extramedullary hematopoiesis (EMH), myelopathy, myelofibrosis, paraparesis

(Received: 18-Mar-13)