Detection of Langerhans cell histiocytosis lesions with somatostatin analogue scintigraphy--a preliminary report.
BACKGROUND
Langerhans cell histiocytosis (LCH) is a disease where granulomatous lesions occur in various organs of the body. The etiology and pathogenesis remain unknown. Inflammatory destructive activity give rise to a wide range of clinical symptoms, including fractures, skin lesions, pulmonary fibrosis, endocrinopathies, and central nervous system deterioration. Since disease activity may ultimately lead to fibrosis and organ damage, it is important to have diagnostic tools to detect disease activity early.


METHODS
The present study was undertaken in order to evaluate whether somatostatin analogue scintigraphy ((111)In-pentetreotide or OctreoScan could be used in detecting LCH granulomas and to compare this method with the radiologic methods used today in LCH diagnosis and follow-up. The somatostatin analogue octreotide used here binds to the cell membrane of activated lymphocytes expressing somatostatin receptors.


RESULTS
In five out of six children studied, LCH lesions detected by other means were also detected with (111)In-pentetreotide. It can be speculated that the lesion in the remaining patient was not active at the time of investigation. In addition, in two of the patients signs of disease activity not previously known were revealed.


CONCLUSIONS
(111)In-pentetreotide can be used to detect active LCH lesions. Since the biologically active somatostatin analogue decreases inflammatory activity, this may also be of therapeutic value in selected patients with LCH. More studies are needed to evaluate the diagnostic and potential therapeutic usefulness of this radionuclide.
Calming
U
U
Childhood Cancer Research Unit at the Department of Pediatrics, Karolinska Hospital, Karolinska Institute, Stockholm, Sweden. ulrika.calming@ks.se
Jacobsson
H
H
Henter
J I
JI
D002648:Child; D002675:Child, Preschool; D005260:Female; D006646:Histiocytosis, Langerhans-Cell / Q000000981:diagnostic imaging*; D006801:Humans; D007205:Indium Radioisotopes / Q000627:therapeutic use; D007223:Infant; D008297:Male; D013004:Somatostatin / Q000031:analogs & derivatives* / Q000627:therapeutic use; D014055:Tomography, Emission-Computed / Q000379:methods*
D007205:Indium Radioisotopes; D013004:Somatostatin; C081788:pentetreotide