Lucent Metaphyseal Bands in Leukemia

General Considerations

• Seen in up to 50% of patients with acute lymphoblastic leukemia
• Believed to represent a disturbance of enchondral ossification
• May become dense bands after treatment
• Most often seen in distal femur, proximal tibia (around knee), proximal humerus, distal radius, ulna

Imaging Findings

• Lucent transverse band in the metaphysis of rapidly growing bones
• Generally appear of uniform thickness across metaphysis

Differential Diagnosis

• Lymphoma
• Congenital infections such as toxoplasmosis, rubella, cytomegalovirus, herpes and syphilis (TORCH infections)
• Metastatic neuroblastoma
• Any prior, severe, usually childhood illness
• Normal variant 

 
Lucent Metaphyseal Bands in Leukemia. Disturbance of enchondral bone formation can produce lucent metaphyseal bands (red arrows are oval) as in this patient with leukemia.

Gamuts in Radiology

Bone changes in hematologic disease. Caffey’s Pediatric Diagnostic Imaging, 11th Ed. 2008