Giger A, Meuret G, Schmid U, Senn H J
Schweiz Med Wochenschr. 1977 Nov 12;107(45):1626-8.
33 years after carotid arteriography with thorotrast a 69-year-old patient died from osteomyelofibrosis with severe hematopoietic hypoplasia and myeloid metaplasia detected in liver, lymph nodes, kidney and epicardium. Twenty years before death he underwent "prophylactic" splenectomy; histologically the spleen merely showed hypoplasia, fibrosis and deposits of thorotrast. It is assumed that the osteomyelofibrosis syndrome is a specific complication of thorotrast application which has only rarely been described in the past. This suggestion is supported by observations suggesting that osteomyelofibrosis syndrome may be induced by radiation and by the fact that thorotrast gives rise to foreign body reactions associated with subsequent severe fibrosis. The development of myeloid metaplasia is assumed to be secondary to chronic hematopoietic insufficiency.
在使用二氧化钍进行颈动脉造影33年后，一名69岁患者死于骨髓纤维化，伴有严重造血发育不全，且在肝脏、淋巴结、肾脏和心外膜发现髓样化生。在死亡前20年，他接受了“预防性”脾切除术；组织学检查显示脾脏仅表现为发育不全、纤维化和二氧化钍沉积。据推测，骨髓纤维化综合征是二氧化钍应用的一种特殊并发症，过去很少被描述。这一推测得到了一些观察结果的支持，这些观察结果表明骨髓纤维化综合征可能由辐射诱发，以及二氧化钍会引发异物反应并随后导致严重纤维化这一事实。髓样化生的发展被认为是继发于慢性造血功能不全。
