Tillmann P, van Kaick G, Heinze A, Intorp H W
Strahlentherapie. 1978 Feb;154(2):94-100.
Thirty-three years after intravascular injection of Thorotrast, a light-chain plasmacytoma with hypercalcemia and renal insufficiency was diagnosed in a 60-year-old man. The question of causal relation between Thorotrast deposit and plasmacytoma is discussed. The accumulated radiation load to the bone-marrow as caused by thorium dioxide deposition amounts to circa 3000 rem. According to casuistic and epidemiological communications, induction of plasmacytomas by external X-irradiation may be regarded as possible. A distinct increase in myeloproliferative diseases but only small numbers of plasmacytomas are reported in extensive epidemiological Thorotrast studies. From combination of results of the three most comprehensive epidemiological Thorotrast studies is obtained a numerical ratio of 1:5 for the spontaneous rate against the number of plasmacytomas observed. Identical correlations are yielded by investigations at Hiroshima and Nagasaki. Hence it is to be supposed that also plasmacytomas can be induced by thorotrastosis of the reticulohistiocytic system.
在血管内注射钍造影剂33年后,一名60岁男性被诊断出患有伴有高钙血症和肾功能不全的轻链浆细胞瘤。文中讨论了钍造影剂沉积与浆细胞瘤之间的因果关系问题。二氧化钍沉积对骨髓造成的累积辐射剂量约为3000雷姆。根据个别病例和流行病学报告,外部X射线照射可能诱发浆细胞瘤。在广泛的钍造影剂流行病学研究中,骨髓增殖性疾病明显增加,但仅报告了少数浆细胞瘤。综合三项最全面的钍造影剂流行病学研究结果,得出自发率与观察到的浆细胞瘤数量之比为1:5。广岛和长崎的调查也得出了相同的相关性。因此,可以推测网状组织细胞系统的钍造影剂沉着也可能诱发浆细胞瘤。