Granulocyte-Stimulating Factor-Induced Bone Marrow Reconversion Simulating Neuroblastoma Metastases on MRI: Case Report and Literature Review

Granulocyte colony–stimulating factor (GCSF), often used as an adjunct to chemotherapy, can pose a dilemma in differentiating the associated bone marrow changes from metastatic disease on magnetic resonance imaging. The phenomenon has been previously reported in children undergoing treatment for primary musculoskeletal malignancies [1 and 2]. We present a case of GCSF-induced marrow reconversion simulating neuroblastoma metastases on MR imaging. An interesting observation in our case was intense abnormal signal in a pattern of metaphyseal bands, which, to our knowledge, was not previously reported in the English literature to be associated with GCSF-induced marrow reconversion.