Myelofibrosis physical examination

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sabawoon Mirwais, M.B.B.S, M.D.[2]

Overview

Patients with myelofibrosis usually appear pale and chronically ill. Physical examination of patients with myelofibrosis is usually remarkable for splenomegaly, hepatomegaly, skin pallor, petechiae and ecchymoses, and lymphadenopathy.

Physical examination

Appearance of the Patient

Vital Signs

Skin

HEENT

Neck

Lungs

Heart

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References

  1. ↑ Shinar Y, Tohami T, Livneh A, Schiby G, Hirshberg A, Nagar M, Goldstein I, Cohen R, Kukuy O, Shubman O, Sharabi Y, Gonzalez-Roca E, Arostegui JI, Rechavi G, Amariglio N, Salomon O (June 2015). "Acquired familial Mediterranean fever associated with a somatic MEFV mutation in a patient with JAK2 associated post-polycythemia myelofibrosis". Orphanet J Rare Dis. 10: 86. doi:10.1186/s13023-015-0298-6. PMC 4506767. PMID 26123310.
  2. ↑ Mitra D, Kaye JA, Piecoro LT, Brown J, Reith K, Mughal TI, Sarlis NJ (December 2013). "Symptom burden and splenomegaly in patients with myelofibrosis in the United States: a retrospective medical record review". Cancer Med. 2 (6): 889–98. doi:10.1002/cam4.136. PMC 3892393. PMID 24403262.
  3. ↑ Mesa RA, Shields A, Hare T, Erickson-Viitanen S, Sun W, Sarlis NJ, Sandor V, Levy RS, Verstovsek S (August 2013). "Progressive burden of myelofibrosis in untreated patients: assessment of patient-reported outcomes in patients randomized to placebo in the COMFORT-I study". Leuk. Res. 37 (8): 911–6. doi:10.1016/j.leukres.2013.04.017. PMID 23684482.
  4. ↑ Finazzi G, Vannucchi AM, Barbui T (November 2018). "Prefibrotic myelofibrosis: treatment algorithm 2018". Blood Cancer J. 8 (11): 104. doi:10.1038/s41408-018-0142-z. PMC 6221891. PMID 30405096.
  5. ↑ Hofmann I, Geer MJ, Vögtle T, Crispin A, Campagna DR, Barr A, Calicchio ML, Heising S, van Geffen JP, Kuijpers M, Heemskerk J, Eble JA, Schmitz-Abe K, Obeng EA, Douglas M, Freson K, Pondarré C, Favier R, Jarvis GE, Markianos K, Turro E, Ouwehand WH, Mazharian A, Fleming MD, Senis YA (September 2018). "Congenital macrothrombocytopenia with focal myelofibrosis due to mutations in human G6b-B is rescued in humanized mice". Blood. 132 (13): 1399–1412. doi:10.1182/blood-2017-08-802769. PMID 29898956. Vancouver style error: initials (help)
  6. ↑ Kc D, Falchi L, Verstovsek S (October 2017). "The underappreciated risk of thrombosis and bleeding in patients with myelofibrosis: a review". Ann. Hematol. 96 (10): 1595–1604. doi:10.1007/s00277-017-3099-2. PMC 5693670. PMID 28808761.
  7. ↑ Complications of primary myelofibrosis. Dr Henry Knipe and Dr Yuranga Weerakkody et al. Radiopaedia 2016. http://radiopaedia.org/articles/myelofibrosis. Accessed on March 10, 2016
  8. ↑ Miyata T, Masuzawa M, Katsuoka K, Higashihara M (July 2008). "Cutaneous extramedullary hematopoiesis in a patient with idiopathic myelofibrosis". J. Dermatol. 35 (7): 456–61. doi:10.1111/j.1346-8138.2008.00502.x. PMID 18705835.
  9. ↑ Corella F, Barnadas MA, Bordes R, Curell R, Espinosa I, Vergara C, Alomar A (May 2008). "[A case of cutaneous extramedullary hematopoiesis associated with idiopathic myelofibrosis]". Actas Dermosifiliogr (in Spanish; Castilian). 99 (4): 297–300. PMID 18394406.
  10. ↑ Kwon KS, Lee JB, Jang HS, Chung TA, Oh CK (June 1999). "A case of cutaneous extramedullary hematopoiesis in myelofibrosis with a preponderance of eosinophilic precursor cells". J. Dermatol. 26 (6): 379–84. PMID 10405485.
  11. ↑ Ruberto E, Espinola R, Brusco J, Bacchiocchi M, Zoppi J, Paz R (April 1995). "[Idiopathic myelofibrosis with extramedullary hematopoiesis foci in the skin and testicles. Report of a case]". Sangre (Barc) (in Spanish; Castilian). 40 (2): 157–60. PMID 7784946.
  12. ↑ Hoffman, Ronald (2018). Hematology : basic principles and practice. Philadelphia, PA: Elsevier. ISBN 9780323357623.
  13. ↑ 13.0 13.1 Panda A, Chandrashekhara SH, Nambirajan A, Mishra P (December 2016). "Idiopathic myelofibrosis with disseminated hepatosplenic, mesenteric, renal and pulmonary extramedullary haematopoeisis, portal hypertension and tuberculosis: initial presentation and 2 years follow-up". BMJ Case Rep. 2016. doi:10.1136/bcr-2016-217854. PMID 28011890.
  14. ↑ 14.0 14.1 Sakatoku K, Takeoka Y, Araki T, Miura A, Fujitani Y, Yamamura R, Miyagi Y, Senzaki H, Ohta K (2017). "Lymphocyte-depleted classical Hodgkin lymphoma accompanied by myelofibrosis". Rinsho Ketsueki (in Japanese). 58 (7): 772–775. doi:10.11406/rinketsu.58.772. PMID 28781273.
  15. ↑ 15.0 15.1 Aljabry MS, Asiri S, Elsafi T, Elyamany G (May 2018). "Generalized lymphadenopathy secondary to isolated extramedullary hematopoiesis as an initial manifestation of primary myelofibrosis". Hematol Rep. 10 (2): 7588. doi:10.4081/hr.2018.7588. PMC 6036984. PMID 30046414.
  16. ↑ Meshchaninova ON (1990). "[A case of osteomyelofibrosis with jaundice]". Sov Med (in Russian) (7): 107–8. PMID 2251548.
  17. ↑ Song ZQ, Zhou LY (October 2010). "[A clinical analysis of six cases of portal hypertension secondary to primary myelofibrosis and review of literatures]". Zhonghua Nei Ke Za Zhi (in Chinese). 49 (10): 845–7. PMID 21162885.
  18. ↑ Saad GM, de Almeida TV (1991). "[Idiopathic myelofibrosis]". Rev Paul Med (in Portuguese). 109 (2): 47–50. PMID 1887177.
  19. ↑ Hoffman, Ronald (2018). Hematology : basic principles and practice. Philadelphia, PA: Elsevier. ISBN 9780323357623.
  20. ↑ Pizzi M, Gergis U, Chaviano F, Orazi A (September 2016). "The effects of hematopoietic stem cell transplant on splenic extramedullary hematopoiesis in patients with myeloproliferative neoplasm-associated myelofibrosis". Hematol Oncol Stem Cell Ther. 9 (3): 96–104. doi:10.1016/j.hemonc.2016.07.002. PMID 27521149.
  21. ↑ Mohyuddin GR, Yacoub A (2016). "Primary Myelofibrosis Presenting as Extramedullary Hematopoiesis in a Transplanted Liver Graft: Case Report and Review of the Literature". Case Rep Hematol. 2016: 9515404. doi:10.1155/2016/9515404. PMC 4739215. PMID 26885416.
  22. ↑ Henry M, Chitlur M, Rajpurkar M, Mastropietro CW, Poulik J, Ravindranath Y (May 2014). "Myelofibrosis, hepatic extramedullary hematopoiesis and ascites associated with vitamin D deficiency in early infancy". J. Pediatr. Hematol. Oncol. 36 (4): 319–21. doi:10.1097/MPH.0b013e31828e548a. PMID 23619118.
  23. ↑ Wei XQ, Zheng ZH, Jin Y, Tao J, Abassa KK, Wen ZF, Shao CK, Wei HB, Wu B (September 2014). "Intestinal obstruction caused by extramedullary hematopoiesis and ascites in primary myelofibrosis". World J. Gastroenterol. 20 (33): 11921–6. doi:10.3748/wjg.v20.i33.11921. PMC 4155387. PMID 25206301.
  24. ↑ Singer A, Quencer R (2014). "Intracranial extramedullary hematopoiesis: a rare cause of headaches". J Neuroimaging. 24 (5): 524–7. doi:10.1111/jon.12029. PMID 23621819.
  25. ↑ 25.0 25.1 Fareed S, Nashwan AJ, Abu Jarir S, Husain A, Suliman DS, Ibrahim F, Moustafa A, Akhter MS, Yassin MA (August 2017). "Spinal Abscess Caused by Salmonella Bacteremia in a Patient with Primary Myelofibrosis". Am J Case Rep. 18: 859–864. PMC 5551928. PMID 28775247.
  26. ↑ 26.0 26.1 Hijikata Y, Ando T, Inagaki T, Watanabe H, Ito M, Sobue G (2014). "[Spinal cord compression due to extramedullary hematopoiesis in a patient with myelofibrosis]". Rinsho Shinkeigaku (in Japanese). 54 (1): 27–31. PMID 24429645.
  27. ↑ Mak YK, Chan CH, So CC, Chan MK, Chu YC (February 2002). "Idiopathic myelofibrosis with extramedullary haemopoiesis involving the urinary bladder in a Chinese lady". Clin Lab Haematol. 24 (1): 55–9. PMID 11843900.
  28. ↑ Kawasaki Y, Nakazora T, Suzukawa M, Tominaga T, Wang ZK, Shinohara K (May 2010). "[Neurological disturbance of the lower extremities by an extramedullary hematopoietic mass complicated with primary myelofibrosis]". Rinsho Ketsueki (in Japanese). 51 (5): 349–52. PMID 20534957.
  29. ↑ Scott IC, Poynton CH (May 2008). "Polycythaemia rubra vera and myelofibrosis with spinal cord compression". J. Clin. Pathol. 61 (5): 681–3. doi:10.1136/jcp.2007.053751. PMID 18441161.
  30. ↑ Ohnishi K, Torimoto Y, Itabashi K, Inamura J, Shindo M, Ikuta K, Sato K, Kohgo Y (October 2005). "[Case of intraspinal epidural tumor developing after systemic mastocytosis with marked osteosclerosis and myelofibrosis]". Rinsho Ketsueki (in Japanese). 46 (10): 1146–51. PMID 16440779.
  31. ↑ de Haas KP, van de Loosdrecht AA, Daenen SM (July 2002). "Intraspinal extramedullary haematopoiesis in a patient with myelofibrosis". Neth J Med. 60 (6): 256–9. PMID 12365470.
  32. ↑ Cook G, Sharp RA (May 1994). "Spinal cord compression due to extramedullary haemopoiesis in myelofibrosis". J. Clin. Pathol. 47 (5): 464–5. PMC 502028. PMID 8027402.
  33. ↑ Saghafi M, Azarian A, Nohesara N (April 2008). "Primary hypertrophic osteoarthropathy with myelofibrosis". Rheumatol. Int. 28 (6): 597–600. doi:10.1007/s00296-007-0477-4. PMID 18038138.
  34. ↑ Pandita KK, Afaq S, Singh D, Mushtaq D, Masood I (February 2012). "Finger clubbing in a patient of myelofibrosis with renal cell carcinoma". J Assoc Physicians India. 60: 124–6. PMID 22715563.
  35. ↑ Hoffman, Ronald (2018). Hematology : basic principles and practice. Philadelphia, PA: Elsevier. ISBN 9780323357623.
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