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On the histopathology of liver and liver tumours in thorium-dioxide patients.

Among 5819 autopsies carried out over the years 1966 to 1969, 6 cases were found having thorotrast deposits in the liver. One case presented non-specific reactive hepatitis, and 5 cases had cirrhosis. The cirrhoses were of the irregular type, in 4 cases with recent and long-lasting confluent necroses, in all 5 cases with extensive passive septa. The morphogenesis of the thorotrast cirrhosis is discussed on the basis of the histological changes. Four of the patients had malignant tumours which are likely to be induced by thorotrast deposits in the liver: mesothelioma, angiosarcoma, hepatoma and cholangiohepatocarcinoma. Angiosarcomas develop relatively frequently in the liver in thorotrast patients, and in the majority of cases these tumours contain large blood-filled cavities. Consequently, liver biopsy without previous angiography is contra-indicated in cases where former intravasal application of thorotrast is known or suspected. In all 6 cases the cause of death is regarded as late effects of thorotrast administration.