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Transudative Pleural Effusion Associated with Extramedullary Hematopoiesis
Keito Enokida1, Katsuyoshi Tomomatsu1, Naoki Okada1
1Division of Pulmonary Medicine, Tokai University School of Medicine, Japan.
Internal Medicine (Tokyo, Japan)
|September 23, 2020
Summary
This case study highlights a rare instance of transudative pleural effusion linked to extramedullary hematopoiesis in an unclassified myeloproliferative neoplasm. Treatment with hydroxyurea effectively managed both thrombocytosis and the effusion.
Area of Science:
- Hematology
- Oncology
- Pulmonology
Background:
- Myeloproliferative neoplasms (MPNs) can present with extramedullary hematopoiesis (EMH).
- Transudative pleural effusions typically result from systemic causes like heart failure or hypoalbuminemia.
Observation:
- A 71-year-old man with thrombocytosis experienced a right-sided transudative pleural effusion unresponsive to diuretics.
- 111In bone marrow scintigraphy revealed EMH in paravertebral soft tissues and the liver.
Findings:
- The patient was diagnosed with an unclassified myeloproliferative neoplasm.
- Administration of hydroxyurea led to a rapid decrease in both platelet count and pleural effusion volume within two weeks.
Implications:
- This case suggests a potential association between EMH secondary to MPNs and transudative pleural effusions.
- Further investigation into the mechanisms linking EMH and pleural fluid dynamics in MPNs is warranted.
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