A Giant Hepatic Hemangioma Complicated by Kasabach-Merritt Syndrome: Findings of Tc-99m RBC Scintigraphy and SPECT Including a Total Body Blood Pool Imaging Study

Kasabach-Merritt 증후군을 동반한 거대 간 혈관종: Tc-99m 적혈구 간 및 전신 혈액풀 신티그래피와 SPECT소견

  • Sohn, Myung-Hee (Department of Nuclear, Chonbuk National University Medical School) ;
  • Jeong, Hwan-Jeong (Department of Nuclear, Chonbuk National University Medical School) ;
  • Lim, Seok-Tae (Department of Nuclear, Chonbuk National University Medical School) ;
  • Kim, Dong-Wook (Department of Nuclear, Chonbuk National University Medical School) ;
  • Yim, Chang-Yeol (Department of Internal Medicine, Chonbuk National University Medical School)
  • 손명희 (전북대학교 의학전문대학원 핵의학교실) ;
  • 정환정 (전북대학교 의학전문대학원 핵의학교실) ;
  • 임석태 (전북대학교 의학전문대학원 핵의학교실) ;
  • 김동욱 (전북대학교 의학전문대학원 핵의학교실) ;
  • 임창열 (전북대학교 의학전문대학원 내과학교실)
  • Published : 2009.02.28

Abstract

Kasabach-Merritt syndrome (KMS) consists of thrombocytopenia, microangiopathic hemolytic anemia, and localized consumption coagulopathy that develops within vascular hemangioma. This syndrome may also be associated with occult hemangiomas located at various sites. Tc-99m RBC scintigraphy and SPECT have proven to be reliable for confirming or excluding hemangioma. Total body blood pool imaging study during the scintigraphy also provides a means of screening for occult lesions. The authors report the case of a 29-year-old man who presented with a giant hepatic hemangioma complicated by KMS, and underwent Tc-99m RBC scintigraphy and SPECT including a total body blood pool imaging study.

Keywords

References

  1. Kasabach HH, Merritt KK. Capillary hemangioma with extensive purpura. Am J Dis Child 1940;59:1063-70 https://doi.org/10.1001/archpedi.1940.01990160135009
  2. Hall GW, Kasabach-Merritt syndrome: pathogenesis and management. Br J Haematol. 2001;112:851-62 https://doi.org/10.1046/j.1365-2141.2001.02453.x
  3. Lim ST, Park SA, Sohn MH, Two patterns of blood pooling in giant hemangiomas on Tc-99m RBC scintigraphy. Clin Nucl Med 2001;26:261-2 https://doi.org/10.1097/00003072-200103000-00026
  4. Groshar D, Ben-Haim S, Gips S, Hardoff R, Jerushalmi J, Parmett S, et al. Spectrum of scintigraphic appearance of liver hemangiomas, Clin Nucl Med 1992;17:294-9 https://doi.org/10.1097/00003072-199204000-00007
  5. Mikami T, Hirata K, Oikawa I. Hemobilia caused by a giant benign hemangioma of the liver: report of a case, Surg Today 1998;28:948-52 https://doi.org/10.1007/s005950050259
  6. Billio A, Pescosta N, Rosanelli C. Zanon GF, Gamba PG, Savastano S, et al. Treatment of Kasabach-Merritt syndrome by embolisation of a giant liver hemangioma. Am J Hmatol 2001;66:140-1 https://doi.org/10.1002/1096-8652(200102)66:2<140::AID-AJH1031>3.0.CO;2-5
  7. Ortel TL, Onorato JJ, Bedrosian CL, Kaufman RE. Antifibrinolytic therapy in the management of the Kasabach Merritt syndrome. Am J Hematol 1988;29:44-8 https://doi.org/10.1002/ajh.2830290111
  8. Nelson RC, Chezmar JL. Diagnostic approach to hepatic hemangiomas. Radiology 1990; 176: 11-3 https://doi.org/10.1148/radiology.176.1.2191359
  9. Rubin RA, Lichtenstein GR. Scintigraphic evaluation of liver masses: cavernous hepatic hemangioma. J Nucl Med 1993;34:849-52
  10. Brodsky RI, Friedman AC, Maurer AH, Radecki PD, Caroline DF. Hepatic cavernous hemangioma: diagnosis with $^{99}TC$-labeled red cells and single-photon emission Ct. AIR Am J Roentgenol 1987;148:125-9 https://doi.org/10.2214/ajr.148.1.125
  11. Middleton ML. Scintigraphic evaluation of hepatic mass lesions: emphasis on hemangioma detection. Semin Nucl Med 1993;26:4-15 https://doi.org/10.1016/S0001-2998(96)80012-2
  12. Loh W Jr, Miller JH, Gomperts ED. Imaging with technetium 99m-labeled erythrocytes in evaluation of the Kasabach-Merritt syndrome. J Pediatr 1988;113:856-9 https://doi.org/10.1016/S0022-3476(88)80017-9
  13. Yang DC, Gould L, Yee WK, Patel D, Maghazeh P, Giovanniello J. Intravenous radionuclide total body arteriography: a new technique. Clin Nucl Med 1988;13:696-700 https://doi.org/10.1097/00003072-198810000-00003
  14. Narayanan G, Yang DC, Tai KG, Wise L, Giovanniello J. Gant hepatic hemangioma studied with intravenous total body arteriography technique, A case report. Clin Nucl Med 1996;21:456-9 https://doi.org/10.1097/00003072-199606000-00004