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Related Experiment Videos

Small intestinal myeloid metaplasia.

D Schreibman1, B Brenner, R Jacobs

  • 1Department of Internal Medicine A, Rambam Medical Center, Haifa, Israel.

JAMA
|May 6, 1988
PubMed
Summary

Extramedullary hematopoiesis, a rare gastrointestinal finding, caused severe bleeding in a patient with myeloid metaplasia. Hydroxyurea therapy significantly reduced bleeding from these submucosal lesions.

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Area of Science:

  • Gastroenterology
  • Hematology
  • Pathology

Background:

  • Extramedullary hematopoiesis (EMH) is uncommon in the gastrointestinal (GI) tract.
  • Postpolycythemic myeloid metaplasia is a myeloproliferative neoplasm.
  • Splenectomy can be a treatment for myeloid metaplasia but may have complications.

Observation:

  • A patient with postpolycythemic myeloid metaplasia and prior splenectomy experienced recurrent GI bleeding.
  • Extensive investigations did not identify the bleeding source.
  • Intraoperative endoscopy revealed multiple submucosal lesions throughout the small bowel.

Findings:

  • The submucosal lesions were diagnosed as extramedullary hematopoiesis.
  • This represents a rare presentation of EMH within the GI tract.

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  • The patient's bleeding was linked to these submucosal hematopoietic sites.

    • Implications:

    • This case highlights the importance of considering EMH in the GI tract for unexplained bleeding, especially in patients with myeloproliferative neoplasms.
    • Hydroxyurea therapy demonstrated efficacy in managing GI bleeding caused by EMH.
    • Further research may explore optimal management strategies for GI extramedullary hematopoiesis.