Warrell R P, Kempin S J, Benua R S, Reiman R E, Young C W
Cancer. 1983 Dec 15;52(12):2256-60. doi: 10.1002/1097-0142(19831215)52:12<2256::aid-cncr2820521216>3.0.co;2-9.
Previous studies regarding sites of platelet destruction in patients with the Kasabach-Merritt syndrome are conflicting. The authors recently studied an adult patient with multiple large hemangiomata, thrombocytopenia, and intravascular coagulation by external imaging following the injection of autologous Indium-111 labeled platelets. Sequential images showed prompt accumulation of platelet-associated radioactivity in areas within the right hemithorax which corresponded to certain tumors noted on the chest roentgenogram. Despite the presence of multiple other lesions in bone and soft tissues, platelet radioactivity was otherwise normally confined to liver and spleen. Using data obtained from serial images, it was shown that radioactivity within the thoracic masses actually increased over time. These data indicate that platelet consumption occurred as an active process and that localization was not a result of tumor vascularity. It is concluded that platelets are locally consumed within certain hemangiomata. However, within the same individual, there may exist considerable heterogeneity among these tumors with respect to platelet-trapping ability. In similar patients with multiple tumors, indium-platelet scanning might be used to direct local therapy to particular lesions in an effort to correct the thrombocytopenia.
以往关于卡萨巴赫 - 梅里特综合征患者血小板破坏部位的研究结果相互矛盾。作者最近对一名患有多发性大血管瘤、血小板减少症和血管内凝血的成年患者进行了研究，在注射自体铟 - 111标记的血小板后采用外部成像技术。连续图像显示血小板相关放射性迅速在右半胸内的区域积聚，这些区域与胸部X线片上发现的某些肿瘤相对应。尽管骨骼和软组织中存在多个其他病变，但血小板放射性在其他方面通常局限于肝脏和脾脏。利用从连续图像获得的数据表明，胸部肿块内的放射性实际上随时间增加。这些数据表明血小板消耗是一个活跃过程，且定位并非肿瘤血管形成的结果。得出的结论是血小板在某些血管瘤内局部被消耗。然而，在同一个体中，这些肿瘤在血小板捕获能力方面可能存在相当大的异质性。在患有多个肿瘤的类似患者中，铟 - 血小板扫描可用于指导针对特定病变的局部治疗，以纠正血小板减少症。
