Objective: Differentiating neoplastic from nonneoplastic bone marrow changes on imaging can be challenging. MRI provides the most helpful information when using T1-weighted and opposed-phase (chemical shift) sequences. We discuss the MRI assessment of bone marrow in the context of a complex clinical case.
Conclusion: The case shows a false-positive result of opposed-phase imaging of bone marrow, which was a postinflammatory cause resulting in marrow fibrosis that mimicked neoplastic marrow infiltration and necessitated biopsy for definitive diagnosis.