A 56 year-old male, who had received angiography by thorotrast about 30 years ago, was admitted to our hospital because of anemia on Nov. 12, '69.
His peripheral blood pictures and sternal marrow features showed the status of the preleukemic stage such as leukemoid reaction until the manifestation of erythroleukemia on Jan. 22, '70.
The specific droplet shadows caused by the deposition of thorotrast could be observed in the x-ray film of the upper abdomen.
He was suffering from severe anemia, epistaxis, hematemesis, flux, hematuria, and infection of lung since the end of March, '70 and at last died of the severe bleeding diathesis on May. 7. '70.
The findings of autopsy were as follows:
1) Thorotrast granules or mass were observed in Glisson sheath, interstitium, and around the central venous vessles of the liver.
2) Especially, the histological findings of the spleen and the bone marrow suggested the causal relation between the atypical proliferation of erythroleukemic cells and the deposition of thorotrast.
3) The tissue of portal lymphnode showed the deposition of thorotrast and slight atrophy.
4) Wide-spread bleeding, sideroblastosis, and necrosis could be seen in the tissue of liver, spleen, lung, digestive tract, and kidney.
5) Fungus disease of lung and adrenocortex atrophy were proved.
It has been reported that most of the malignant tumors induced by thorotrast were epithelial tumors such as cholangioma or liver cartinoma and non-epithelial tumors induced by thorotrast were very rere in Japan.
But in Europe and America, non-epithelial tumors such as liver sarcoma, Hodgkin's sarcoma, leukemia etc. were reported to occupy about 40% of all malignant tumors induced by thorotrast.
This case report of the acute erythroleukemia induced by thorotrast is considered the first or second case in Japan.
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