Gaucher-like cells in retroperitoneal extramedullary hematopoietic tumor diagnosed by fine needle aspiration: a case report.

BACKGROUND

Extramedullary hematopoiesis (EMH) can present as a diffuse lesion or as a solitary mass. EMH is most commonly seen in patients with hematologic disorders and rarely in asymptomatic patients. The liver, spleen and lymph nodes are the most common EMH sites. However, EMH has also been seen at unusual sites, including adrenal glands, breast, thymus, thyroid, kidney, epididymis, lung, pleura, peripheral nerves and dura mater. The diagnosis of this lesion on fine needle aspiration (FNA) smears has rarely been described.

CASE: A 20-year-old man with Cooley's anemia presented with a retroperitoneal tumor for the past 3 months that was clinically diagnosed as malignant. Ultrasonographically guided FNA cytology showed bone marrow cells composed of myelocytes, lymphocytes, erythroblasts and megakaryocytes, which were consistent with an extramedullary hematopoietic tumor. Histologic sections of the excised tumor confirmed the FNA diagnosis. Interestingly, Gaucher-like cells were frequently seen in the smears.

CONCLUSION

The FNA findings of EMH can be confused with those of inflammatory pseudotumor, Hodgkin lymphoma, myeloproliferative disorders and granulocytic sarcoma. Clinical history can be helpful for interpreting FNA findings in an EMH diagnosis.