Hepatocellular carcinoma, 48 years after Thorotrast injection

A 70-year-old-man developed hepatocellular carcinoma with lung metastasis, 48 years after Thorotrast injection. Histologically Thorotrast particles were found in the liver, spleen, bonemarrow, lymph nodes and adrenals. In the liver most of the Thorotrast particles were found around the vessels (central and portal veins), mainly in clumps lying free in the connective tissue of the portal spaces or less frequently in the cytoplasm of macrophages. The presence of Thorotrast was frequently found to be associated with fibrosis and the intensity of these changes was nearly proportional to the amount of Thorotrast present. The patient died in secondary heart failure. (author)