Vinyl-chloride-induced liver disease. From idiopathic portal hypertension (Banti's syndrome) to Angiosarcomas

• Published in: The New England journal of medicine Vol. 292; no. 1; p. 17
• Main Authors: Thomas, L B, Popper, H, Berk, P D, Selikoff, I, Falk, H
• Format: Journal Article
• Language: English
• Published: United States 02.01.1975
• Subjects: Autopsy; Biopsy; Chemical and Drug Induced Liver Injury - etiology; Environmental Exposure; Hemangiosarcoma - chemically induced; Hemangiosarcoma - pathology; Humans; Hydrocarbons, Chlorinated - adverse effects; Hyperplasia; Hypersplenism - chemically induced; Hypersplenism - pathology; Hypertension, Portal - chemically induced; Hypertension, Portal - pathology; Hypertrophy; Liver - pathology; Liver Cirrhosis - chemically induced; Liver Cirrhosis - pathology; Liver Neoplasms - chemically induced; Liver Neoplasms - pathology; Occupational Diseases - chemically induced; Occupational Diseases - pathology; Polyvinyls - adverse effects; Spleen - pathology; Splenomegaly - pathology; Time Factors; Vinyl Compounds - adverse effects
• ISSN: 0028-4793
• DOI: 10.1056/NEJM197501022920104

Histologic examination of liver tissue (eight autopsy and 18 biopsy specimens) and five spleens from 20 workers with vinyl chloride polymerization showed hepatic angiosarcomas in 15. In addition, a peculiar pattern of progressive portal-tract, inconspicuous intralobular and conspicuous capsular fibrosis was observed in the five workers without angiosarconma, in all the seven patients with angiosarcoma from whom tumor-free portions of the liver were available, and in two tumor-free biopsies from patients subsequently found to have angiosarcoma. The fibrosis was accompanied by splenomegaly. Hypertrophy and hyperplasia of both hepatocytes and hepatic and splenic mesenchymal cells were also seen. The histologic similarity to chronic inorganic arsenical poisoning, in which angiosarcomas also occur, and to idiopathic portal hypertension (Banti's syndrome) suggests that the latter syndrome at times results from unknown toxic, possible environmental, chemicals.