CT characteristics of intrahepatic, periportal, extramedullary hematopoiesis

Area of Science:

• Hepatology
• Hematology
• Radiology

Background:

• Primary myelofibrosis is a myeloproliferative neoplasm characterized by bone marrow fibrosis.
• Extramedullary hematopoiesis (EMH) is the formation of blood cells outside the bone marrow, often occurring in myelofibrosis.
• Intrahepatic EMH is a rare manifestation, typically involving the spleen and liver.

Observation:

• A case of primary myelofibrosis presenting with intrahepatic periportal extramedullary hematopoiesis is described.
• Imaging findings on computed tomography (CT) and sonography revealed characteristic periportal abnormalities.
• Autopsy pathological correlation confirmed the presence of extramedullary hematopoiesis in the periportal region.

Findings:

• The study highlights the CT and sonographic appearance of intrahepatic periportal extramedullary hematopoiesis in primary myelofibrosis.
• Pathological examination confirmed the imaging findings, establishing a direct correlation.
• This specific pattern of EMH can mimic other periportal pathologies.

Implications:

• Radiologists and clinicians should consider primary myelofibrosis in the differential diagnosis of periportal abnormalities on CT.
• Accurate diagnosis of intrahepatic EMH is crucial for appropriate patient management and prognosis.
• This case expands the understanding of the imaging spectrum of extramedullary hematopoiesis in myeloproliferative neoplasms.