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Acute surgical abdomen and myelofibrosis
H M Payan1, I W Grossman, M Pelaez
1Department of Pathology, Uniontown Hospital, Pennsylvania.
Abstract:
Extramedullary hematopoiesis associated with fibrosis is found frequently in the liver and spleen, but seldom in other organs. Acute abdomen due to extramedullary hematopoiesis has been reported in two patients with intestinal obstruction because of heavy infiltration of the terminal ileum. This report describes the case of a 71-year-old woman with myeloid metaplasia involving the gallbladder mimicking acute cholecystitis. As far as we know, involvement of the gallbladder by extramedullary hematopoiesis has never been reported before.
Insights
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.