37-year-old woman with known dyserythropoiesis who reported pain after trauma
Pre-sacral Extramedullary hematopoiesis
Lobulated, pre-sacral lesion, similar T1 and T2 hypointense characteristic as the adjacent sacral bodies.
Mild bone expansion with T1 hyper-intense foci,, which could be due to prevertebral hematoma and combined fat deposits.
Soft tissue density lesion immediately in front of the sacrum which did not cause any bone erosion or destruction.
Extramedullary hematopoiesis (EMH) is a non-neoplastic proliferation of hematopoietic tissue outside the bone marrow and peripheral blood that is typically a reaction to various hematologic disorders that result in abnormal bone marrow production or function.
The MRI signal in these cases was variable and appeared to be dependent on the proportion of red marrow and fat in the mass. Most of these cases demonstrated isointense or hypointense signal (relative to skeletal muscle) on T1-weighted and T2-weighted images, corresponding to red marrow.
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