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Unusual clivus lesion demonstrating extramedullary haematopoiesis: case report

Published online by Cambridge University Press:  08 March 2017

K Kulendra ,
C Butler ,
W Grant ,
A Sandison ,
G Cho  and
M C Patel
K Kulendra*
Affiliation:
Department of ENT, Charing Cross Hospital, London, UK
C Butler
Affiliation:
Department of Histopathology, Charing Cross Hospital, London, UK
W Grant
Affiliation:
Department of Histopathology, Charing Cross Hospital, London, UK
A Sandison
Affiliation:
Department of Histopathology, Charing Cross Hospital, London, UK
G Cho
Affiliation:
Department of Neuroradiology, Charing Cross Hospital, London, UK
M C Patel
Affiliation:
Department of Haematology, Central Middlesex Hospital, London, UK
*
Address for correspondence: Mr Kevin Kulendra, 25 Buxton Drive, New Malden, Surrey KT3 3UX, UK. Fax: +44 (0)20 8395 0117 E-mail: knk79@blueyonder.co.uk
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Abstract

Introduction:

An unusual clivus mass is reported, following investigation of memory disturbance and headaches in a patient with β thalassaemia and sickle cell disease. This lesion proved to be a site of extramedullary haematopoiesis.

Radiological findings:

Computed tomography demonstrated a 2 cm mass at the base of the sphenoid. However, magnetic resonance imaging showed little bony expansion, and the differential diagnosis included chordoma, dermoid cyst and fibrodysplasia.

Histological findings:

Examination of the biopsy showed the presence of bone marrow demonstrating erythroid hyperplasia and small aggregates of B-cell lymphocytes. The features were considered compatible with erythroid hyperplasia associated with haemolytic anaemia.

Management:

The patient was reassured that she did not have a neoplastic lesion, and was referred back to the haematologists for further management of her sickling β thalassaemia.

Conclusions:

Extramedullary haematopoiesis occurs outside the reticuloendothelial system in response to haemolytic anaemia. Extramedullary haematopoiesis causing a clivus mass is an unusual ENT presentation. Such haematopoiesis is occasionally seen in the calvarial skull, but this is the first report of this process occurring in the anterior skull base, to our knowledge.

Keywords

Extramedullary HaematopoiesisSphenoid SinusClivusB ThalassaemiaSickle Cell Disease
Type
Online Only Clinical Records
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 5 , May 2009 , e15
Copyright
Copyright © JLO (1984) Limited 2009

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