Interesting ImagesExtensive Extramedullary Hematopoiesis in Thalassemia Soft Tissue Uptake on 99mTc-MDP SPECT/CTUsmani, Sharjeel MS, FEBNM, KBNM∗; Ahmed, Najeeb FRCP, FRCR†; Muzaffar, Samreen MRCGP†; Al Kandari, Fareeda KBNM∗Author Information From the ∗Department of Nuclear Medicine, Kuwait Cancer Control Center (KCCC), Khaitan, Kuwait †Hull and East Yorkshire Hospitals NHS Trust, Hull, United Kingdom. Received for publication February 19, 2020; revision accepted May 19, 2020. Conflicts of interest and sources of funding: none declared. Correspondence to: Sharjeel Usmani, MS, FEBNM, KBNM, Department of Nuclear Medicine, Kuwait Cancer Control Center, PO Box 1488, 83001 Khaitan, Kuwait. E-mail: firstname.lastname@example.org. Clinical Nuclear Medicine: October 2020 - Volume 45 - Issue 10 - p e459-e460 doi: 10.1097/RLU.0000000000003191 Buy Metrics Abstract We report the case of a 45-year-old man with thalassemia major referred for a bone scan as a workup for generalized bone pain. 99mTc-MDP SPECT CT showed multiple elongated soft tissue masses along the inner aspects of ribs and along both sides of dorsal spine with calcification and mild tracer uptake. There was also a large lobulated presacral soft tissue mass displacing the bladder and involving the adjacent pelvic bone. Biopsy of mildly avid tracer uptake in pelvic soft tissue mass was extramedullary hematopoiesis confirmed by biopsy. Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.