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Myeloid metaplasia, i.e., the formation of bone marrow elements outside of the medullary cavity, may occur in any patient with anemia, regardless of the etiology of the anemia itself. The spleen is frequently the site of myeloid metaplasia, and it may present with varying degrees of splenomegaly; however, no cases have been reported where this entity presented as an isolated splenic mass. Our case was a 79-yr-old man who presented with anemia and a splenic mass by CT scan and who underwent fine-needle aspiration (FNA) of that mass. The smears revealed megakaryocytes admixed with other hematopoietic elements. No fatty elements were identified in the smears. We conclude that splenic myeloid metaplasia may present as a discrete splenic mass lesion, and may be diagnosed using the FNA technique.
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