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Acute surgical abdomen and myelofibrosis
H M Payan1, I W Grossman, M Pelaez
1Department of Pathology, Uniontown Hospital, Pennsylvania.
Summary
Extramedullary hematopoiesis, a condition usually affecting the liver and spleen, rarely occurs elsewhere. This case report details a rare instance of myeloid metaplasia in the gallbladder, mimicking acute cholecystitis.
Area of Science:
- Hematology
- Gastroenterology
- Pathology
Background:
- Extramedullary hematopoiesis (EMH) is the formation of blood cells outside the bone marrow.
- EMH commonly occurs in the liver and spleen, often associated with myelofibrosis.
- While EMH can cause intestinal obstruction, gallbladder involvement is exceptionally rare.
Observation:
- A 71-year-old woman presented with symptoms suggestive of acute cholecystitis.
- Diagnostic imaging revealed myeloid metaplasia infiltrating the gallbladder.
- This presentation mimicked typical gallbladder inflammation.
Findings:
- The patient was diagnosed with myeloid metaplasia involving the gallbladder.
- This represents the first reported case of extramedullary hematopoiesis in the gallbladder.
- The condition mimicked acute cholecystitis, highlighting a diagnostic challenge.
Implications:
- This case expands the known anatomical sites of extramedullary hematopoiesis.
- It underscores the importance of considering rare diagnoses in atypical presentations.
- Recognition of gallbladder EMH is crucial for accurate diagnosis and management of myeloid metaplasia.