TWO CASES OF CIRRHOTIC LIVER ASSOCIATED WITH THOROTRAST DEPOSITS
In the first case, a woman aged 59, admitted to the hospital because or intermittent laundice and ascites, had an abnormal radiograph of the upper abdomen, showing deposits of opaque material in the liver and spleen and calcified lymph nodes. Diagnostic cerebral angiography had been performed through the left common carotid artery for suspected brain tumor because of epileptic seizures at the age of 41. Autopsy in this case showed cirrhosis with Thorotras deposits in the densely hyalinized interstitial tissue. Diffuse adenomatous proliferation of cholangiocellular origin was associated with nodular fibrosis near the Thorotrast deposit throughout over the liver, although this was not of a malignant nature. The splenic parenchyma was dcgenerated, and Thorotrast particles were seen in the follicular areas, but there was no fibrosis. Thorotrast aggregates were detected in the lymph nodes, in bone marrow, and in the scar-like mass surrounding the left common carotid artery where Thorotrast had been injected 19 yr previously. In the second case, a 48-yr-old male developed a slight fever, nausea, and vomiting before being admitted to the hospital. X rays revealed abnormal, dense honeycomb-like reticular patterns in liver and spleen. A biopsied skin lesion, suspected of being a metastatic tumor, was diagnosed as hemangioendothelioma. He died of the primary hepatic tumor. Necropsy findings included hemorrhagic malignant changes of the liver associated with bizarre fibrosis and focal calcification, fibrosis of the spleen, a small nodule in the left shoulder region, and a hard mass in the left cubital region. Although an accurate history of Thorotrast injection could not be elicited, deposition of raihoactive particles was detected in the spleen and liver, and in the subcutaneous hard mass in the left cubital region where the injection presumably was made. The histologicai pattern of the mass in the presumed injection site indicated a nodular proliferation of hyalinized dense connective tissue bearing Thorotrast, accompanied by only slight cellular reaction, and referred to as a Thorotrast granuloma. The spleen was hardened by thick fibrous tissue and focal calcification, and the follicles were almost completely replaced by Thorotrast-laden cells and hyalinized fibrous tissue. Hemangioendothelioma or endothelioma-like granulomatous proliferation in the liver was associated with Thorotrast-laden fibrosis and hemorrhage. It is evident that Thorotrast fibrosis is preceded by phagocytosis by reticuloendothelial cells, and accompanied by minimal inflammatory response and subsequent damage of the cells. It seems probable that the radiation effect of Thorotrast is more responsible for the characteristic Thorotrast fibrosis than the mechanical influence of the particles. In a discussion of this article by other investigators, three new cases of Thorotrast deposits in liver are reported, one of them accompanied by malignancy (a cholangiocarcinoma). (BBB)
- Research Organization:
- Hokkaido Univ., Sapporo
- NSA Number:
- NSA-17-038756
- OSTI ID:
- 4645495
- Journal Information:
- Acta Pathol. Japan., Vol. Vol: 10: Suppl.; Other Information: Orig. Receipt Date: 31-DEC-63
- Country of Publication:
- Country unknown/Code not available
- Language:
- English
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