Pure erythropoiesis in clear cell renal cell carcinoma

Extramedullary hematopoiesis (EMH) is a phenomenon in which benign immature hematopoietic cells are found in sites other than the bone marrow. Although usually associated with an underlying hematologic abnormality such as myelofibrosis, it can be found in some physiologic states or occasionally within solid tumors. In most instances, foci of EMH contain elements of all cell lineages. Presented here is the second reported case of EMH occurring in a low-grade clear cell renal cell carcinoma in a patient without evidence of hematologic disease. As previously, it manifested as pure erythropoiesis as confirmed by morphology and immunohistochemistry. It is possible that this finding is related to erythropoietin secretion by the tumor and not hematologic malignancy.