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[Cholangiocarcinoma in a patient with hepatosplenic atrophy subsequent to thorotrast administration (author's transl)].

A case of cholangiocarcinoma observed in a woman of 38 following carotidographic examination with Thorotrast is described: the presence of radioactivity was also demonstrated by gamma spectrometry. The high mean dose absorbed by the liver (estimated at about 3,000 rad) together with the high relative biological effectiveness of the alpha contribution and the time lapse justify the hypothesis that the neoplasia was caused by irradiation.

Adenoma, Bile Duct↗

Quantitative CT for determination of thorium in thorotrast patients.

The concentrations of thorium in the liver, spleen, and their efferent lymph nodes were determined in six thorotrast patients by quantitative CT scanning. Thorium concentration per CT number was calibrated by scanning a phantom that contained a known concentration of thorium nitrate solution. The total amount of thorium determined by the quantitative CT method in the liver, spleen, and lymph nodes was compared with that determined by gamma-ray measurement of the upper abdomen using a whole body counter. A linear relationship was obtained between the amount of thorium determined by the CT method and that determined by the gamma-ray measurement method, although the correlation was not high. The quantitative CT method appears to be useful for determining, with some accuracy, the concentration of thorium in the liver, spleen, and lymph nodes of thorotrast patients.

Gamma Rays↗

[Thorotrastosis--a rare disease picture in internal medicine].

The report deals with the late effects following administration of thorotrast in a 63-year-old patient: liver cirrhosis developed after application of thorotrast 25 years ago. The clinical findings are described and attention is drawn to the relevance of this disease at present time. The authors refer to the significance of the routine X-ray diagnosis and of the CT for finding a diagnosis with thorotrastosis.

Humans↗

Roentgenologic appearance of a thorotrast-induced small cholangiocarcinoma in a case of thorotrastosis. An autopsy case of massive gastrointestinal bleeding of esophageal varices.

A small cholangiocarcinoma was detected at autopsy in a patient with thorotrastosis who died from the rupture of esophageal varices at the esophagogastric junction. Prior to the advent of recent diagnostic imaging technique, a correct antemortem diagnosis could only be obtained from tumor markers. However, the tendency for the opacity of the liver to decrease slowly with time and develop uneven trabeculation suggests that small tumors may be difficult to detect against such a non-homogeneous background.

Adenoma, Bile Duct↗

[Thorotrast].

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Contrast Media↗

Increased risk of death in thorotrast-exposed patients during the late follow-up period.

To evaluate the effects of continuous low-level ionizing radiation on humans, the follow-up data (1980-85) on Japanese thorotrast-exposed patients were analyzed. The patients were 241 war-wounded military personnel registered with and cared for by the Ministry of Health and Welfare since 1979. During this period, a total of 1144 person-years, 94 patients died. Compared with the expected number of deaths calculated from age- and cause-specific death rates in Japan during the same period, the thorotrast-exposed patients were at three times greater risk of death from all causes (P less than 0.001), had 47 times the risk of liver cancer (P less than 0.001), 12 times the risk of leukemia (P less than 0.05), and 20 times the risk of liver cirrhosis (P less than 0.001). Age at time of thorotrast injection, drinking and smoking habits had little effect on these statistics. Analyses of 30 autopsied patients with liver cancer showed statistically significantly increases in hemangiosarcoma and cholangiocarcinoma. The thorotrast-exposed patients' estimated risk of liver cancer by histological type was 21 times that of the general population for hepatocellular carcinoma, 303 times that for cholangiocarcinoma and 3129 times that for hemangiosarcoma.

Aged↗