A known patient with thalassemia major post splenectomy and cholecystectomy with bilateral paraspinal masses likely extramedullary hematopoiesis. Extramedullary hematopoiesis affects organs, that are usually radiographic evidence of their enlargement, e.g. hepatomegaly, splenomegaly seen by ultrasound, CT or MRI. Lesions are typically hypermetabolic and hence is FDG-18 avid on PET-CT.¹