Post-thrombocythemic myeloid metaplasia with pleural involvement and the duration of response to external beam radiation therapy: a case report and literature review

Autor: Churilla, Thomas, Saidman, Bruce, Mullen, Matthew, Peters, Christopher
Zdroj: Journal of Radiation Oncology; June 2012, Vol. 1 Issue: 2 p195-198, 4p
Abstrakt: Extramedullary hematopoiesis (EMH) of the lung is a rare clinical phenomenon associated with chronic hemolytic anemias and myeloproliferative diseases. Pulmonary EMH has documented sensitivity to ionizing radiation which translates to an efficacious therapy. The optimal local management of EMH of the lung with radiotherapy is uncertain because of the low incidence of cases. Herein, we describe the case of a 93-year-old gentleman with a 30-year history of essential thrombocythemia who developed extramedullary hematopoiesis of the lung. He was treated with two separate courses of whole lung external beam radiation with a durable response of approximately 4 months on both occasions. We discuss his clinical course, management, and a comparison to the current literature.Extramedullary hematopoiesis (EMH) of the lung is a rare clinical phenomenon associated with chronic hemolytic anemias and myeloproliferative diseases. Pulmonary EMH has documented sensitivity to ionizing radiation which translates to an efficacious therapy. The optimal local management of EMH of the lung with radiotherapy is uncertain because of the low incidence of cases. Herein, we describe the case of a 93-year-old gentleman with a 30-year history of essential thrombocythemia who developed extramedullary hematopoiesis of the lung. He was treated with two separate courses of whole lung external beam radiation with a durable response of approximately 4 months on both occasions. We discuss his clinical course, management, and a comparison to the current literature.
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