PMC7328483_01
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PMC7328483_03
PMC7328483_04
(A) Pachymeningeal thickening along parietotemporal regions caused by
extramedullary hematopoiesis at dura mater (large arrows). (B) Although
partial response was shown in meningeal involvement after radiation therapy
on whole brain, progressive extramedullary hematopoiesis developed along the
posterior aspect of spinal canal from C5 to S5, which caused diffuse cord
compression (small arrows). (C) Previously involved lesions were
dramatically improved in brain MRI checked at 6 months post-HCT.. HCT, hematopoietic cell transplantation; MRI, magnetic resonance imaging.
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Brain MRI showed diffuse meningeal thickening along parieto-temporal regions (Figure 1A), and dura biopsy revealed an increased number of hematopoietic precursors of all lineages. Diplopia was aggravating, with visual disturbance, and back pain and paraplegia developed despite radiation therapy (Figure 1B). Although herpes zoster infection occurred, no GVHD developed, follow-up BM showed improved fibrosis with MF-2 grade, and meningeal lesions on follow-up MRI totally disappeared at 6 months post-HCT (Figure 1C).