Vinyl-chloride-induced liver disease. From idiopathic portal hypertension (Banti's Syndrome) to angiosarcomas.
Thomas-LB; Popper-H; Berk-PD; Selikoff-I; Falk-H
N Engl J Med 1975 Jan; 292(1):17-22
The effect of vinyl-chloride (75014) (VC) on liver disease among exposed workers was histologically investigated. Specimens of liver tissue were examined. Eighteen of these showed angiosarcoma. Eight samples were from autopsies and 10 were from biopsy examinations. Another five samples were from patients with hepatic fibrosis without known angiosarcoma. These were obtained from surgical and needle biopsy. Observations of the splenic changes were made on three surgical and two autopsy specimens. Sinusoidal, papillary and cavernous patterns were evident in the angiosarcomas. In addition, 25 percent of the angiosarcomas had more solid nodules of anaplastic sarcoma. In three other patients, other organs beside the liver showed evidence of angiosarcoma: the lung, heart, kidney, and lymph nodes in one patient; the duodenum in another patient; and the lung in a third patient. The patients with hepatic fibrosis had proliferation of bile ducts, single hepatocytes, and groups of hepatocytes at the margins of the portal tracts. Some of the walls of portal vein branches showed focal fibrosis. The splenic changes showed enlargement, hyperplastic Malphigian follicles, and widened red pulp sinuses. The authors conclude that the relationship between hepatic angiosarcomas and exposure to vinyl-chloride has been established. Many vinyl-chloride workers have identical symptoms resembling Banti's syndrome; inconspicuous hepatic fibrosis, splenomegaly, and portal hypertension. Banti's syndrome may result from environmental exposure to chemicals, possibly vinyl- chloride.
NIOSH-Publication; NIOSH-Grant; Monomers; Occupational-exposure; Chemical-properties; Toxicology; Histopathology; Liver-cancer; Toxic-effects; In-vivo-study; Hepatotoxicity; Pulmonary-system-disorders; Polymerization; Plastics-industry; Vinyl-plastics; Liver-cells; Liver-disorders; Liver-damage
Community Medicine Mount Sinai School of Medicine Fifth Avenue and 100 Street New York, N Y 10029
New England Journal of Medicine
Mount Sinai School of Medicine, New York, New York