indium-oxine and Hemangioma

A 66-yr-old woman with cutaneous angiosarcoma of the face presented with thrombocytopenia and metastases to the skeleton. Scintigraphic imaging with 111In-oxine-labeled autologous platelets demonstrated localization of radiolabeled platelets at sites of metastatic tumor. This imaging study suggests intratumoral destruction of platelets by the metastases of the malignant vascular tumor as the cause of the patient's thrombocytopenia.

Topics: Aged; Blood Platelets; Bone Neoplasms; Facial Neoplasms; Female; Hemangioma; Humans; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Thrombocytopenia

We have utilized 111In-labeled heterologous platelets to investigate the mechanism of thrombocytopenia in ten children. From the scintigraphic findings, platelet survival times, and clinical information, thrombocytopenia was ascribed to decreased production or to increased destruction. Two patients were found to have bone marrow production defects. Two patients with hemangiomas were studied. In one, the hemangioma was shown not to be the cause of thrombocytopenia. In the second, the hemangioma was proven the source of platelet destruction, but was much more extensive than clinically evident. In both, surgical manipulation of the hemangioma was avoided. Six additional patients had thrombocytopenia due to accelerated destruction. In four, the spleen was shown responsible. In two, however, the spleen was shown not to be responsible for the low platelet counts, and splenectomy was avoided. Thus, 111In-platelet scintigraphy and survival studies are valuable in the classification and management of childhood thrombocytopenia. We believe that this study should be performed, when possible, in any child with thrombocytopenia where the mechanism is unclear or the therapeutic intervention involves splenectomy or resection of a hemangioma.

Topics: Adolescent; Blood Platelets; Cell Survival; Child; Child, Preschool; Hemangioma; Humans; Indium Radioisotopes; Infant; Organometallic Compounds; Oxyquinoline; Platelet Count; Radionuclide Imaging; Splenectomy; Thrombocytopenia

A 4-year-old boy presented with consumptive coagulopathy suspected to be due to Kasabach-Merritt syndrome. Localization of homologous indium-111 platelets in the region of the right sacral ala confirmed that this was the site of disease and facilitated radiation treatment, which proved to be curative.

Topics: Blood Platelets; Child, Preschool; Hemangioma; Humans; Hydroxyquinolines; Indium; Male; Organometallic Compounds; Oxyquinoline; Radionuclide Imaging; Spinal Neoplasms; Syndrome; Thrombocytopenia