A 25-year follow-up study of heavily exposed vinyl chloride workers in Germany.

The course of vinyl chloride-induced disease observed in 21 polyvinyl chloride (PVC) production workers, covering the period from first exposure to diagnosis and finally to death, and the difficulties in elucidating the true character of the lesions and their occupational origin are described. In 19 cases death was due to malignant hepatoma, predominantly angiosarcoma of the liver, but hepatocellular and cholangiocellular carcinoma were also found. Two workers died of complications of noncirrhotic portal fibrosis with portal hypertension.

Multiple nodular foci in the liver associated with chronic hepatic porphyria after previous treatment of breast cancer.

More than 7 years after the diagnosis and treatment of breast cancer (T1N1aM0), multiple nodular foci were observed in the liver of a 40-year-old woman at ultrasonographic examination. The lesions were confirmed by CT scan, but CT-guided liver biopsy revealed only non-specific alterations. At subsequent peritoneoscopic examination, bluish-brown foci were indeed visible on the liver surface, but guided liver biopsies again failed to corroborate the suspected metastases.

[Fulminant liver failure in tuberculostatic therapy. A contribution to clinical aspects and pharmacokinetics].

A 23-year old female patient on a prolonged regimen of tuberculostatic chemotherapy finally developed fulminant hepatic failure shortly after addition of hormonal contraception. The pathophysiology of this almost fatal drug reaction is described as a pharmacokinetic interaction: the inherent hepatotoxicity of prothionamide-the drug finally prescribed during convalescence-was significantly potentiated by the Cyt-P-450-inducing effect of the progestagen component of the hormonal contraceptive. Potentiation of hepatotoxicity in connection with tuberculostatic regimes containing rifampicin is well known and this pharmacokinetic phenomenon also pertains to the combination with other Cyt-P-450-inducing drugs such as, for instance, anticonvulsants.

[The liver and environmental poisons].

For almost a century now numerous examples of acute and subacute hepatic injury from exposure to toxic agents in the occupational or non-occupational environment have been extensively studied and are well documented, but such events are comparatively rare. In contrast, epidemiological data associating exposure to environmental chemicals with chronic liver disease or primary hepatic malignancies in the human is scarce as compared with the vast body of literature concerning chronic pulmonary disease as a consequence of exposure at the workplace. Large-scale industrial production of many newly synthesized organic chemicals began during the period 1930-1940 but it was not until the 1960s that the output increased exponentially.

[Malignant mesenchymal liver tumors in the computed tomogram].

The computer tomographic appearances of very rare sarcomas of the liver have been demonstrated in five cases (four haemangiosarcomas, one spindle-cell sarcoma). On the plain scan, all the tumours appeared less dense than the liver parenchyma, but in haemangiosarcomas there was a marked increase in density after the infection of contrast up to an isodense level. During angio-CT, densities equal to intrahepatic vessels were observed.