Radiological Aspects of Marrow Heterotopia in Thalassemia

  • C. Papavasiliou


Synonyms of “marrow heterotopia” (MH) are “extramedullary hemopoiesis” and “myeloid metaplasia.” The purpose of this paper is to review the subject of MH in β-Thalassemia. Although MH is not a new entity to the pathologists, it is a comparatively recent one from the clinical, radiological, and therapeutic standpoint. Lately, computerized tomography (CT) has contributed to a more thorough investigation of MH [20]. In this paper, MH will be reviewed on the basis of existing reports and the author’s experience, extending over 20 years. MH occurs in about 16% of patients with thalassemia major or intermedia.


Spinal Cord Compression Pernicious Anemia Thalassemia Major Posterior Mediastinum Extramedullary Hemopoiesis 
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  1. 1.
    Andreou J, Gouliamos A, Kalovidouris A, Papailiou J, Papavasiliou C (1984) Bone marrow hyperplasia of the maxillary sinuses inß-thalassemia. J Comput Assis Tomogr 8: 180CrossRefGoogle Scholar
  2. 2.
    Ask-Upmark E (1945) Tumour simulating intra-thoracic heterotopia of bone marrow. Acta Radiol (Stockh) 26: 425–440CrossRefGoogle Scholar
  3. 3.
    Chao P, Farman J, Rapelner S (1986) CT features of presacral mass. An unknown focus of extra-medullary hemopoiesis. J Comp Assist Tomogr 10: 684–687CrossRefGoogle Scholar
  4. 4.
    Close A, Taira Y, Clevaland D (1958) Spinal cord compression due to extremedullary hematopoiesis. Ann Intern Med 48: 421–427PubMedGoogle Scholar
  5. 5.
    Fessas P, Loukopoulos D (1974) fi-thalassemia. Clin Haematol 3: 411Google Scholar
  6. 6.
    Gatto J, Terrana V (1964) Compressione sil midollo spinale da proliferazione di midollo osseo nello spazio epidulare in sogetto affetto da malattia die Cooley splenectomizzatio. Haematologica (Pavia) 38: 61–75Google Scholar
  7. 7.
    Hanford R, Schneider G, MacCarthy J (1960) Massive thoracic extra-medullary hemopoiesis. N Engl J Med 263: 120–121PubMedCrossRefGoogle Scholar
  8. 8.
    Irvin RA, Robertson WB (1964) Spinal cord compression in malignant lymphomas. Br Med J 1: 1354–1356CrossRefGoogle Scholar
  9. 9.
    Kniseley RM, Andrews GA, Edwards CL, Tanida R (1964) Scanning of bone marrow hematopoietic disorders. IAEA Symposium on Medical Radioisotope Scanning, AthensGoogle Scholar
  10. 10.
    Knoblich R (1960) Extramedullary hemopoiesis presenting as intrathoracic mass. Report of case in patient with thalassemia minor. Cancer 13: 462–468CrossRefGoogle Scholar
  11. 11.
    Litwer H (1969) Myelolipoma of the mediastinum. Radiology 74: 471–472Google Scholar
  12. 12.
    Lowman R, Bloor C, Newcomb A (1963) Roentgen manifestations of thoracic extramedullary hematopoiesis. Dis Chest 44: 154–162PubMedCrossRefGoogle Scholar
  13. 13.
    Lyall A (1935) Massive extramedullary bone-marrow formation in a case of pernicious anemia. J Pathol Bacteriol 41: 469–470CrossRefGoogle Scholar
  14. 14.
    Malmos B, Papavasiliou C, Avramidis A (1962) Tumour-simulating intrathoraic extramedullary hemopoiesis: report of case. Acta Radiol 57: 227–231CrossRefGoogle Scholar
  15. 15.
    Marinozzi V (1958) Aspetti insoliti dell’ iperplasia midollare nelle anemie emolitiche. Haematologica (Pavia) 43: 737–740Google Scholar
  16. 16.
    Papavasiliou C (1965) Tumour-simulating intra-thoracic extramedullary hemopoiesis. AJR 93: 695–702Google Scholar
  17. 17.
    Papavasiliou C, Sfikakis P (1964) Tumour simulation intrathoracic marrow heterotopia in thalassemia major. Thorax 19: 121–124PubMedCrossRefGoogle Scholar
  18. 18.
    Papavasiliou C, Konstantoulakis M, Priovolos J et al. (1979) The anterior costal margin mass in thalassemia major. Clin Radiol 30: 521–524PubMedCrossRefGoogle Scholar
  19. 19.
    Papavasiliou C (1982) Radiotherapy of symptomatic tumor-simulating extramedullary hemopoiesis. IntJ Radiat Oncol Biol Phys 8: 1813–1814CrossRefGoogle Scholar
  20. 20.
    Papavasiliou C, Andreou J, Stringaris K, Vlahos L, Pontifex G (1982) The CT findings of extra-medullary hematopoiesis. Radiologe 22: 86–87PubMedGoogle Scholar
  21. 21.
    Scutellari PN, Franceschini J, Orzincolo C (1982) Skeletal changes in treatedß-thalassemia X-rays. Rome 13–25, 82.Google Scholar
  22. 22.
    Sorsdahl OS, Taylor PE, Noyes WD (1964) Extramedullary hemopoiesis, mediastinal masses, spinal cord compression. J Am Med Assoc 189:343–347Google Scholar

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© Springer-Verlag Berlin Heidelberg 1989

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  • C. Papavasiliou

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