Sickle cell disease presenting with intrahepatic extramedullary hematopoiesis: MRI characterization and diagnostic clues

Extramedullary hematopoiesis (EMH) refers to the formation of hematopoietic tissue outside the bone marrow and usually occurs in response to chronic anemia or marrow dysfunction. While EMH is well-documented in conditions such as thalassemia and myeloproliferative disorders, intrahepatic extramedullary hematopoiesis is very rarely documented in sickle cell disease. We present the MRI imaging features of a rare case of intrahepatic extramedullary hematopoiesis in a patient with sickle cell disease. Given the potential for misdiagnosis as primary hepatic malignancy or as infectious lesions, this case report underscores the importance of recognizing the imaging features of intrahepatic extramedullary hematopoiesis in the context of sickle cell disease and chronic transfusion-related iron overload.