Marrow Hyperplasia in β-Thalassemia: Pathophysiology, Imaging Insights, and Clinical Implications
DOI: 10.1056/NEJMicm066861 Keywords: marrow hyperplasia, β-thalassemia, bone marrow expansion, radiographic features, differential diagnosis, hematology, skeletal changes, chronic anemia Abstract Marrow hyperplasia, also known as bone marrow expansion or medullary hyperplasia, represents a compensatory physiological response to chronic anemia or hematologic stress. It is a hallmark of several inherited and acquired disorders, including β-thalassemia. This article provides a comprehensive discussion of marrow hyperplasia from pathophysiological mechanisms to radiological interpretation, diagnostic differentials, and management, illustrated through a clinical case of a 39-year-old woman with β-thalassemia major. This discussion integrates the latest literature and aims to serve as a concise yet authoritative review for clinicians, radiologists, and medical examinees. 1. Case Summary A 39-year-old woman with β-thalassemia major has required monthly red blood cell transfusio...