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[Renal extramedullary hematopoiesis. Case report].

Diana Vanessa Suárez A, María Del Rosario Alvarez V, Juan Pablo Rojas H

Revista Chilena De Pediatria

|February 21, 2015

Summary

Extramedullary hematopoiesis (EMH), the formation of blood cells outside bone marrow, is rarely seen. This case highlights renal EMH as a response to chronic hypoxia, not bone marrow disease.

Area of Science:

Nephrology
Hematology
Pathology

Background:

Extramedullary hematopoiesis (EMH) is the development of blood cell lines outside the bone marrow.
EMH is typically a rare condition, often documented in case reports.

Observation:

A 16-year-old presented with symptoms of chronic hypoxia, including cyanosis and clubbing, living at high altitude.
Investigations revealed pulmonary hypertension and bilateral renal pelvic masses.
The patient exhibited polycythemia, prompting further examination of the bone marrow and renal masses.

Findings:

Bone marrow aspiration excluded malignant pathology.
Renal mass biopsy confirmed extramedullary hematopoiesis involving all three hematopoietic cell lines.
The findings suggest EMH as a compensatory response to chronic hypoxia.

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Implications:

This case suggests chronic hypoxia, potentially due to untreated pulmonary hypertension, can be a primary driver for renal EMH.
It challenges the traditional view of EMH solely as a consequence of bone marrow pathology.
Highlights the importance of considering hypoxia in the differential diagnosis of renal masses with associated polycythemia.