Significance of abnormal indium In 111-labeled leukocyte accumulation in the head and neck region

The localization of occult infection is often a difficult clinical problem. In 1975, labeling of leukocytes with indium In 111 became technically feasible, and subsequent clinical experience with 111In-labeled leukocyte scanning demonstrated high sensitivity and specificity for acute infection. To our knowledge, experience with white blood cell scanning in the head and neck has not been previously reported. The University of California, San Francisco, experience with 111In-labeled white blood cell scanning was reviewed. Between 1982 and 1987, 520 whole-body 111In-labeled leukocyte studies were performed, of which 60% were interpreted as abnormal. Eighteen studies were abnormal in the head and neck region, and the medical records of these patients were retrospectively reviewed. Abnormal findings correlated with other evidence of disease that involved mucosal surfaces, the neck, and the mediastinum. Sites in the nasopharynx with nasogastric tubes and tracheotomy sites were abnormal without associated clinical evidence of infection. Further clinical experience is needed to correlate white blood cell scan findings with disease in the head and neck and to define the role of the scan in diagnosis and management of otolaryngological disorders.