Contrast-Enhanced Ultrasound Reveals a Rare Pseudo-Malignant Lesion: Intrahepatic Extramedullary Hematopoiesis

Extramedullary hematopoiesis (EMH) is a rare condition where hematopoietic tissue forms outside the bone marrow. We present a case of a patient with long-standing myelofibrosis and thalassemia, diagnosed with intrahepatic EMH (IEMH) through surgical pathology. This case describes its etiology, pathogenesis, and the causes of misdiagnosis, mainly focusing on the characteristics of contrast-enhanced ultrasound (CEUS) and magnetic resonance imaging (MRI) of IEMH. The MRI manifestations of IEMH are diverse due to differences in the age and activity of the lesions. Notably, it provides the first description of IEMH's enhancement pattern on CEUS, a potential unique imaging feature of this condition.