EXTRAMEDULLARY HEMATOPOIESIS MANIFESTING AS A SYMPTOMATIC PLEURAL EFFUSION

The occurrence of extramedullary hematopoiesis in the pleura is rare a nd is usually asymptomatic. It is generally diagnosed on postmortem ex amination, Herein we describe a 61-year-old woman with agnogenic myelo id metaplasia who sought medical assessment because of progressive dys pnea, Thoracentesis yielded sanguineous fluid with 10% myeloblasts. A Tc-99m bone marrow scan demonstrated increased tracer activity through out both lungs, an outcome consistent with extramedullary hematopoiesi s. Fine-needle aspiration and video-assisted thoracoscopy were conside red but deferred because of the potential risk of profuse bleeding, Tr eatment with low-dose external beam irradiation to the left posterior pleura was successful, To date, no hemothorax has recurred.