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Diffusely discordant In-111 WBC/Tc-99m SC bone marrow uptake. A possible chemotherapeutic effect
1Department of Radiology, New England Medical Center, Boston, Massachusetts, USA.
Clinical Nuclear Medicine
|July 1, 1995
Summary
In-111 white blood cell (WBC) scintigraphy showed absent bone marrow activity in a patient with relapsed acute lymphoid leukemia. Technetium-99m sulfur colloid imaging confirmed normal marrow function, suggesting chemotherapy effects on reticuloendothelial function.
Area of Science:
- Nuclear medicine
- Hematology
- Oncology
Background:
- Acute lymphoid leukemia (ALL) relapse requires accurate assessment of bone marrow involvement.
- Nuclear imaging techniques are crucial for evaluating organ function and disease infiltration.
Observation:
- In-111 WBC scintigraphy revealed markedly reduced bone marrow uptake.
- Simultaneously, liver and spleen showed normal white blood cell uptake.
- Technetium-99m sulfur colloid (SC) imaging demonstrated normal marrow distribution and function.
Findings:
- Bone marrow biopsy confirmed hypocellular, regenerating marrow without leukemic infiltration.
- Discordant imaging findings suggest a functional abnormality rather than direct leukemic infiltration of the marrow.
- Chemotherapy-induced suppression of reticuloendothelial function is a potential cause for the absent marrow activity on In-111 WBC scans.
Implications:
- This case highlights the importance of correlating different imaging modalities and biopsy results in managing relapsed leukemia.
- Understanding chemotherapy's impact on marrow imaging is vital for accurate interpretation.
- Further research may elucidate the specific mechanisms of chemotherapy affecting marrow scintigraphy in leukemia patients.