the authors report a case of a 40-year-old male patient with sickle cell disease who presented with intra-thoracic extramedullary hematopoiesis and paravertebral expansive lesions that appeared as soft tissue density masses on conventional x-ray films. a computed tomography of the chest demonstrated soft tissue density masses in the lower third of the paravertebral spaces. these masses presented well-defined limits, lobulated edges and were heterogeneous due to areas of interposed adipose and soft density tissues. the lung parenchyma had no abnormalities. computed tomography of the abdomen revealed diffuse hiperdensity and enlargement of the liver that was attributed to hemosiderosis, and an atrophic and calcified spleen due to repeated episodes of infarction.