Focal Hematopoietic Hyperplasia of Rib: A Rare Pseudotumor and Review of Literature

Primary tumors of the rib are uncommon, comprising 5%– 10% of all bony tumors. Benign tumors constitute 63% of this group [1]. Common benign entities include osteochondroma, enchondroma, and fibrous dysplasia, while common malignant tumors of the ribs include plasmacytoma, chondrosarcoma, osteosarcoma, and Ewing’s sarcoma [1]. Focal hematopoietic hyperplasia (FHH) is an unusual benign lesion characterized by an expansive osteolytic mass involving the rib in all reported cases [2-4]. Most cases were detected incidentally on routine chest radiography performed for unrelated reasons. The lesion is typically composed of hypercellular marrow containing all three lineages of hematopoietic cells with interspersed fatty marrow; no hematopoietic dyspoiesis or malignancy is seen. Though clinical signs and radiological features of the lesion often simulate a true neoplasm, in reality it is a pseudotumor. Follow-up investigation has failed to show any recurrence or neoplastic transformation after resection of the lesion [2]. To the best of our knowledge, to date only four cases have been reported in the English literature [2-4]. We report a case of FHH in the right second rib in a 26-year-old female who underwent surgery after radiological diagnosis of osteochondroma.

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