Gelatinous Transformation of Bone Marrow Mimicking Malignant Marrow-Replacing Lesion on Magnetic Resonance Imaging in a Patient without Underlying Devastating Disease

Abstract

Gelatinous transformation of bone marrow is characterized by hypoplasia of fat cells with focal loss of hematopoietic cells and deposition of extracellular gelatinous substances. It is known to be associated with devastating underlying diseases that starve bone marrow. Here, we present a case of a patient whose magnetic resonance (MR) imaging findings of vertebral column were interpreted as metastasis or hematologic malignancy, however, the final diagnosis revealed a gelatinous transformation of bone marrow. This is the first report of gelatinous transformation of bone marrow without evidence of underlying devastating disease.

MRI findings in serous atrophy of bone marrow in spinal imaging

“…It is characterized by the atrophy of fatty marrow and the loss of hematopoietic cells in the body or skeleton, replaced by an accumulation of extracellular mucinous substances. The gelatinous malformation of bone marrow is not a normal disease but instead indicates an underlying illness that starves the bone marrow, particularly the fatty marrow (6)(7)(8)(9)(11)(12).…”

“…This article presents a case report of the 'fl ip-fl op' phenomenon in serous atrophy of bone marrow (SABM) and GTBM pathology, where MR images appear to be a technical failure but are a specifi c imaging pattern related to the clinical problem. SABM is the rare and potentially reversible cause of diff use changes in the bone marrow and subcutaneous adipose tissue, which appear on MR images (1)(2)(3)(4)(5). SABM is also referred to as gelatinous bone marrow transformation (GTMB) or 'starvation marrow' , more frequently in adult male patients.…”