摘要：目的：分析西双版纳傣族自治州地中海贫血髓外造血组织瘤样增生与胸部髓脂肪瘤的临床与CT影像学特征，筛选出可鉴别地中海贫血胸部髓外造血组织瘤样增生与胸部髓脂肪瘤的独立性影响因素。方法：选择2020年1月至2024年12月我院接诊的40例地中海贫血胸部髓外造血组织瘤样增生患者为病例组，选择同期就诊的40例胸部髓脂肪瘤患者为对照组进行回顾性分析。收集并比较两组患者一般资料及CT影像学特征，以多因素Logisitc回归筛选出独立性影响因素。结果：病例组与对照组性别、年龄、BMI、病灶最大径差异均无统计学意义（P>0.05），两组病灶部位、病灶数量、病灶形态、密度、强化情况差异均具有统计学意义（P<0.05）。多因素Logistic回归分析结果显示：病灶数量（OR=4.526，95%CI=1.258~16.281）、病灶形态（OR=0.310，95%CI=0.104~0.927）、密度（OR=6.704，95%CI=1.145~39.256）、强化情况（OR=4.062，95%CI=1.078~15.308）为地中海贫血髓外造血组织瘤样增生的鉴别两种疾病的独立性影响因素（P<0.05）。结论：病灶数量、病灶形态、密度等CT影像学特征可用于鉴别地中海贫血胸部髓外造血组织瘤样增生与胸部髓脂肪瘤。

目的 探讨纵隔髓外造血(EMH)的临床特点,从而为其诊断、治疗提供参考意见。方法 总结分析我科收治的1例双侧后纵隔骨髓外造血组织多发瘤样增生,并对近10年来国内相关文献报道的27例病例进行回顾性分析。结果 患者需行手术活检取得病理诊断,确诊髓外造血。结论 纵隔髓外造血瘤样增生是一种罕见特殊的良性病变, 预后良好。但因其临床表现和影像学均缺乏特异性,当临床中遇到发生在后纵隔脊柱旁的占位性病变,同时患有贫血的患者应考虑EMH 的可能性,给予经皮穿刺或者胸腔镜下活检来取得细胞学诊断,从而避免不必要的手术治疗。

Objective To probe into the clinical features of mediastinal extramedullary hematopoiesis (EMH), for providing a reference for clinical diagnosis and treatment. Methods The clinical data was studied in a case of mediastinal EMH from our department, and 27 case reports from domestic published literatures over the last decade were analyzed retrospectively. Results Of the 27 patients, 15 received surgical excision, while the other 12 underwent needle biopsy. In our patient, the diagnosis of EMH was made by mini thoracotomy and open biopsy. Conclusion Mediastinal EMH is a rare disease and its prognosis is well. Because there is no obvious specific clinical symptoms and imaging appearances, the possibility of EMH should be considered when a patient with a mediastinal tumor associated with anemia is encountered. Diagnosis can be achieved by needle biopsy or video-assisted thoracic surgery (VATS) in order to prevent unnecessary surgical procedures.