Uptake of 111In-labeled leukocytes by tumor

The 111In-labeled leukocyte scan is a sensitive and specific technique for the detection and localization of abscesses. However, in reviewing an unselected series of 249 scans, six (2.3%) were false-positive cases in which leukocyte uptake by tumor mimicked an abscess. This represented 12% (6/51) with known tumor at the time of imaging. Five of the cases were primary or metastatic tumors to the soft tissues; the sixth was a skeletal metastasis. The intensity of tumor activity has been characterized as mild in the few cases of leukocyte uptake reported in the literature, suggesting that the degree of uptake is helpful in distinguishing tumor from abscess. In this study, however, variable degrees of tumor-associated activity were seen ranging from mild to very intense. These findings indicate that tumor accumulates labeled leukocytes more frequently than has been previously appreciated, that primary and metastatic neoplasms involving both the soft tissues and skeleton are involved, and that the intensity of uptake is not a reliable criterion to distinguish tumor from abscess.