Extramedullary hematopoiesis in the adrenal gland

Last revised by Doaa Khedr Mohamed Khedr on 18 Nov 2022

Extramedullary hematopoiesis in the adrenal gland is a rare physiologic compensatory event in many hematologic diseases.

For a general discussion on this subject, please refer to the main article on extramedullary hematopoiesis.

Epidemiology

Extramedullary hematopoiesis in the adrenal gland is uncommon 2. Instead, it occurs most commonly in the spleen, liver, and lymph nodes and less frequently in the lung, pleura, breast, thymus, small bowel, and central nervous system 1.

Pathology

The adrenal glands might be involved unilaterally or bilaterally 4. Although rare, there are few reports describing extramedullary hematopoiesis in the adrenal gland in patients with thalassemia 3.

The exact mechanism of extramedullary hematopoiesis in the adrenal gland is unknown. Several hypotheses include 5:

  • adrenal gland has hematopoietic capacity during the fetal period and extramedullary hematopoiesis may develop from primitive rests
  • embolization of hematopoietic stem cells in adrenal gland may occur
  • there may be chronic hypoxia 4,6

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