An elderly woman admitted with large bowel obstruction. On rectal
examination, a tumor could be felt prolapsing down into the rectum.
At laparotomy the large and small bowel mesentery was seen to be studded with what was initially thought to be tumor. This was biopsied and eventually shown to be areas of extramedullary haemopoiesis. The patient had chronic myeloid leukaemia and myelodysplasia. The usual sites of extramedullary haemopoiesis are the liver and spleen, but the process may occur anywhere there is lymphoid tissue - including the gut mesentery.
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