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Asymptomatic spherocytosis presenting with spinal cord compression: case report
Florian Jalbert1, Patrick Chaynes, Jacques Lagarrigue
1Department of Neurosurgery, CHU Rangueil, Toulouse, France.
Journal of Neurosurgery. Spine
|May 6, 2005
Summary
Extramedullary hematopoiesis (EMH) can cause spinal cord compression, even without anemia. This case highlights EMH presenting as a spinal mass, requiring surgical decompression for symptom relief.
Area of Science:
- Neurology
- Hematology
- Radiology
Background:
- Extramedullary hematopoiesis (EMH) is a known compensatory response to chronic anemia, typically associated with conditions like thalassemia.
- While EMH commonly occurs in the spleen or liver, epidural spinal involvement is rare.
Observation:
- A 57-year-old man presented with spinal cord compression due to a posterior epidural mass identified via MRI from T-3 to T-6.
- The patient had no prior history of anemia or hematological disorders, but subsequent tests revealed asymptomatic spherocytosis.
Findings:
- Histological examination confirmed the epidural mass as EMH.
- Despite the presence of spherocytosis, anemia was absent, making the diagnosis of EMH atypical.
Implications:
- This case underscores that EMH can manifest as spinal cord compression even in the absence of overt anemia.
- Surgical decompression was effective in alleviating symptoms, and the MR imaging findings were crucial for diagnosis.
- The unusual presentation emphasizes the importance of considering EMH in the differential diagnosis of spinal epidural masses.