Myelofibrosis CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]

Overview

CT scan may be helpful in the diagnosis of myelofibrosis. Findings on CT scan suggestive of myelofibrosis include diffuse bone sclerosis.

CT

CT scan may be helpful in the diagnosis of myelofibrosis.
Findings on CT scan suggestive of myelofibrosis can be divided into:

Skeletal CT Findings

Diffuse osteosclerosis^[1]
Sandwich vertebrae (increased radiodensity or condensation of bone at the superior and inferior margins of the vertebral body)

Head CT Findings

Irregular, lobulated, high density, interhemispheric masses that extend along the falx cerebri and containing areas of lower attenuation centrally.^[2]
Bilateral high density tentorial thickening

Chest CT Findings

Pulmonary extramedullary hematopoiesis (EMH) manifesting as:

Atypical diffuse groundglass opacity^[3]
Pulmonary nodules
Interstitial thickening
Multiple soft tissue masses in bilateral thoracic cavities^[4]

Abdominal CT Findings

Thrombus formation in the visceral vasculature^[5]^[6]^[7]
Bilateral renal enlargement (as a result of extramedullary hematopoiesis)^[8]^[9]^[10]^[11]
Bilateral adrenal gland enlargement (as a result of extramedullary hematopoiesis)^[12]
Splenomegaly^[13]^[9]^[14]^[6]
Hepatomegaly^[9]^[15]^[16]^[6]
Ascites^[6]

CT Images

Axial bone CT image demonstrating diffuse bone sclerosis. Source: Case courtesy of Radswiki, Radiopaedia.org, rID: 11649

Abdominal CT image demonstrating hepatosplenomegaly (Arrow heads) and diffuse bone sclerosis (Arrows). Source: Case courtesy of Dr Henry Knipe, Radiopaedia.org, rID: 53374

References

↑ Guermazi A, de Kerviler E, Cazals-Hatem D, Zagdanski AM, Frija J (1999). “Imaging findings in patients with myelofibrosis”. Eur Radiol. 9 (7): 1366–75. doi:10.1007/s003300050850. PMID 10460376.
↑ Urman M, O’Sullivan RA, Nugent RA, Lentle BC (June 1991). “Intracranial extramedullary hematopoiesis. CT and bone marrow scan findings”. Clin Nucl Med. 16 (6): 431–4. PMID 1868657.
↑ Yang M, Roarke M (March 2017). “Diffuse pulmonary extramedullary hematopoiesis in myelofibrosis diagnosed with technetium-99m sulfur colloid bone marrow scintigraphy and single photon emission computerized tomography/CT”. Am. J. Hematol. 92 (3): 323–324. doi:10.1002/ajh.24616. PMID 27883206.
↑ Qiu D, Hu X, Xu L, Guo X (2015). “Extramedullary hematopoiesis on 18F-FDG PET/CT in a patient with thalassemia and nasopharyngeal carcinoma: A case report and literature review”. J Cancer Res Ther. 11 (4): 1034. doi:10.4103/0973-1482.150359. PMID 26881631.
↑ Magyari F, Bedekovics J, Décsy J, Ilonczai P, Illés Á, Simon Z (April 2018). “[Investigation and treatment of prefibrotic/early primary myelofibrosis. A case study]”. Orv Hetil (in Hungarian). 159 (15): 603–609. doi:10.1556/650.2018.30995. PMID 29631428.
↑ ^6.0 ^6.1 ^6.2 ^6.3 Kobayashi A, Sugihara M, Kurosaki M, Ishida Y, Takayanagi N, Matsui O, Takashima T (1989). “CT characteristics of intrahepatic, periportal, extramedullary hematopoiesis”. J Comput Assist Tomogr. 13 (2): 354–6. PMID 2925932.
↑ Zirinsky K, Auh YH, Rubenstein WA, Morrison HS, Sherman SJ, Kazam E (April 1987). “Computed tomography appearance of adrenal vein thrombosis”. J Comput Tomogr. 11 (2): 216–8. PMID 3472774.
↑ Imai K, Aoi T, Kitai H, Endo N, Fujino M, Ichida S (November 2017). “A case of perirenal extramedullary hematopoiesis in a patient with primary myelofibrosis”. CEN Case Rep. 6 (2): 194–199. doi:10.1007/s13730-017-0274-1. PMC 5694411. PMID 28895103.
↑ ^9.0 ^9.1 ^9.2 Orphanidou-Vlachou E, Tziakouri-Shiakalli C, Georgiades CS (June 2014). “Extramedullary hemopoiesis”. Semin. Ultrasound CT MR. 35 (3): 255–62. doi:10.1053/j.sult.2013.12.001. PMID 24929265.
↑ Ginzel AW, Kransdorf MJ, Peterson JJ, Garner HW, Murphey MD (August 2012). “Mass-like extramedullary hematopoiesis: imaging features”. Skeletal Radiol. 41 (8): 911–6. doi:10.1007/s00256-011-1323-z. PMID 22101909.
↑ La Fianza A, Torretta L, Spinazzola A (2005). “Extramedullary hematopoiesis in chronic myelofibrosis encasing the pelvicaliceal system and perirenal spaces: CT findings”. Urol. Int. 75 (3): 281–4. doi:10.1159/000087809. PMID 16215320.
↑ King BF, Kopecky KK, Baker MK, Clark SA (1987). “Extramedullary hematopoiesis in the adrenal glands: CT characteristics”. J Comput Assist Tomogr. 11 (2): 342–3. PMID 3819139.
↑ Song MK, Chung JS, Lim SN, Lee GW, Lee SM, Lee NK, Choi JC, Oh SY (October 2016). “Usefulness of spleen volume measured by computed tomography for predicting clinical outcome in primary myelofibrosis”. Int. J. Hematol. 104 (4): 476–84. doi:10.1007/s12185-016-2050-y. PMID 27349913.
↑ Ito A, Umeda M, Koike T, Naruse S, Fujita N (March 2006). “[A case of dermatomyositis associated with chronic idiopathic myelofibrosis]”. Rinsho Shinkeigaku (in Japanese). 46 (3): 210–3. PMID 16642932.
↑ La Fianza A, van der Byl G, Maccabelli G, Torretta L, Calliada F (2010). “CT and MR findings in extramedullary haematopoiesis with biliary system encasement: a case report”. J Radiol Case Rep. 4 (11): 1–8. doi:10.3941/jrcr.v4i11.462. PMC 3303353. PMID 22470696.
↑ Kwak HS, Lee JM (August 2000). “CT findings of extramedullary hematopoiesis in the thorax, liver and kidneys, in a patient with idiopathic myelofibrosis”. J. Korean Med. Sci. 15 (4): 460–2. doi:10.3346/jkms.2000.15.4.460. PMC 3054659. PMID 10983698.

Template:WikiDoc Sources

[pmid10460376-1] Guermazi A, de Kerviler E, Cazals-Hatem D, Zagdanski AM, Frija J (1999). “Imaging findings in patients with myelofibrosis”. Eur Radiol. 9 (7): 1366–75. doi:10.1007/s003300050850. PMID 10460376.

[pmid1868657-2] Urman M, O’Sullivan RA, Nugent RA, Lentle BC (June 1991). “Intracranial extramedullary hematopoiesis. CT and bone marrow scan findings”. Clin Nucl Med. 16 (6): 431–4. PMID 1868657.

[pmid27883206-3] Yang M, Roarke M (March 2017). “Diffuse pulmonary extramedullary hematopoiesis in myelofibrosis diagnosed with technetium-99m sulfur colloid bone marrow scintigraphy and single photon emission computerized tomography/CT”. Am. J. Hematol. 92 (3): 323–324. doi:10.1002/ajh.24616. PMID 27883206.

[pmid26881631-4] Qiu D, Hu X, Xu L, Guo X (2015). “Extramedullary hematopoiesis on 18F-FDG PET/CT in a patient with thalassemia and nasopharyngeal carcinoma: A case report and literature review”. J Cancer Res Ther. 11 (4): 1034. doi:10.4103/0973-1482.150359. PMID 26881631.

[pmid29631428-5] Magyari F, Bedekovics J, Décsy J, Ilonczai P, Illés Á, Simon Z (April 2018). “[Investigation and treatment of prefibrotic/early primary myelofibrosis. A case study]”. Orv Hetil (in Hungarian). 159 (15): 603–609. doi:10.1556/650.2018.30995. PMID 29631428.

[pmid2925932-6] 6.0 ^6.1 ^6.2 ^6.3 Kobayashi A, Sugihara M, Kurosaki M, Ishida Y, Takayanagi N, Matsui O, Takashima T (1989). “CT characteristics of intrahepatic, periportal, extramedullary hematopoiesis”. J Comput Assist Tomogr. 13 (2): 354–6. PMID 2925932.

[pmid3472774-7] Zirinsky K, Auh YH, Rubenstein WA, Morrison HS, Sherman SJ, Kazam E (April 1987). “Computed tomography appearance of adrenal vein thrombosis”. J Comput Tomogr. 11 (2): 216–8. PMID 3472774.

[pmid28895103-8] Imai K, Aoi T, Kitai H, Endo N, Fujino M, Ichida S (November 2017). “A case of perirenal extramedullary hematopoiesis in a patient with primary myelofibrosis”. CEN Case Rep. 6 (2): 194–199. doi:10.1007/s13730-017-0274-1. PMC 5694411. PMID 28895103.

[pmid24929265-9] 9.0 ^9.1 ^9.2 Orphanidou-Vlachou E, Tziakouri-Shiakalli C, Georgiades CS (June 2014). “Extramedullary hemopoiesis”. Semin. Ultrasound CT MR. 35 (3): 255–62. doi:10.1053/j.sult.2013.12.001. PMID 24929265.

[pmid22101909-10] Ginzel AW, Kransdorf MJ, Peterson JJ, Garner HW, Murphey MD (August 2012). “Mass-like extramedullary hematopoiesis: imaging features”. Skeletal Radiol. 41 (8): 911–6. doi:10.1007/s00256-011-1323-z. PMID 22101909.

[pmid16215320-11] La Fianza A, Torretta L, Spinazzola A (2005). “Extramedullary hematopoiesis in chronic myelofibrosis encasing the pelvicaliceal system and perirenal spaces: CT findings”. Urol. Int. 75 (3): 281–4. doi:10.1159/000087809. PMID 16215320.

[pmid3819139-12] King BF, Kopecky KK, Baker MK, Clark SA (1987). “Extramedullary hematopoiesis in the adrenal glands: CT characteristics”. J Comput Assist Tomogr. 11 (2): 342–3. PMID 3819139.

[pmid27349913-13] Song MK, Chung JS, Lim SN, Lee GW, Lee SM, Lee NK, Choi JC, Oh SY (October 2016). “Usefulness of spleen volume measured by computed tomography for predicting clinical outcome in primary myelofibrosis”. Int. J. Hematol. 104 (4): 476–84. doi:10.1007/s12185-016-2050-y. PMID 27349913.

[pmid16642932-14] Ito A, Umeda M, Koike T, Naruse S, Fujita N (March 2006). “[A case of dermatomyositis associated with chronic idiopathic myelofibrosis]”. Rinsho Shinkeigaku (in Japanese). 46 (3): 210–3. PMID 16642932.

[pmid22470696-15] La Fianza A, van der Byl G, Maccabelli G, Torretta L, Calliada F (2010). “CT and MR findings in extramedullary haematopoiesis with biliary system encasement: a case report”. J Radiol Case Rep. 4 (11): 1–8. doi:10.3941/jrcr.v4i11.462. PMC 3303353. PMID 22470696.

[pmid10983698-16] Kwak HS, Lee JM (August 2000). “CT findings of extramedullary hematopoiesis in the thorax, liver and kidneys, in a patient with idiopathic myelofibrosis”. J. Korean Med. Sci. 15 (4): 460–2. doi:10.3346/jkms.2000.15.4.460. PMC 3054659. PMID 10983698.

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Myelofibrosis CT

Overview

CT

Skeletal CT Findings

Head CT Findings

Chest CT Findings

Abdominal CT Findings

CT Images

References

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