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October 28, 1983

Extramedullary Hematopoiesis Presenting as a Pelvic Mass in a Patient With β-Thalassemia Intermedia

JAMA. 1983;250(16):2178-2179. doi:10.1001/jama.1983.03340160064034

PATIENTS with β-thalassemia intermedia often have radiological bone and soft-tissue findings of extra-medullary hematopoiesis. Most often described in the thorax and cranium, these soft-tissue masses may be found at any site along the vertebral column.

Report of a Case  During a yearly pelvic examination, a 36-year-old black woman was noted to have a pelvic mass. At age 12, a diagnosis of β-thalassemia major (homozygous) intermedia was made.Examination disclosed that the liver was palpable 3 cm below the right costal margin and an enlarged spleen was detected 7 cm below the left costal margin. The uterus was of normal size and displaced anteriorly; the adnexae were normal. A 6-cm cul-de-sac mass was described as firm, immobile, nontender, and smooth. The superior border could not be delineated.The hematocrit reading was 25.5%, and the WBC count was 5,600/cu mm, with a normal differential cell count. Erythrocyte indexes were microcytic and hypochromic.