Mass-Forming Extramedullary Hematopoiesis in Multiple Myeloma: 18 F-FDG PET/CT is useful in Excluding Extramedullary Myeloma Involvement

Abstract

Aims and background

Extramedullary hematopoiesis (EMH), a benign condition, is usually observed in patients with hematologic disorders. We report the first case of mass-forming EMH detected on a ¹⁸F-fluoro-2-deoxy-D-glucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) scan in a patient with multiple myeloma (MM).

Methods

A 58-year-old woman underwent workup for bicytopenia, and was diagnosed with MM based on the results of bone marrow aspiration and serum protein electrophoresis. An ¹⁸F-FDG PET/CT scan revealed a paravertebral mass with mild FDG avidity, suggesting a tumorous condition.

Results

Biopsy was performed to exclude malignancy and the mass was eventually confirmed as EMH.

Conclusions

Differential diagnosis of a mildly FDG-avid paravertebral mass in MM should include EMH.

Keywords

Extramedullary hematopoiesis Mediastinal Multiple myeloma Paravertebral Positron emission tomography

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