Vinyl-Chloride-Induced Liver Disease

TLDR

Histologic similarity to chronic inorganic arsenical poisoning and idiopathic portal hypertension suggests that these syndromes may arise from unknown environmental toxins. Among 20 vinyl‑chloride workers, 15 had hepatic angiosarcomas, while the others displayed progressive portal‑tract fibrosis with splenomegaly and hepatocyte and mesenchymal cell hypertrophy/hyperplasia.

Abstract

Histologic examination of liver tissue (eight autopsy and 18 biopsy specimens) and five spleens from 20 workers with vinyl chloride polymerization showed hepatic angiosarcomas in 15. In addition, a peculiar pattern of progressive portal-tract, inconspicuous intralobular and conspicuous capsular fibrosis was observed in the five workers without angiosarconma, in all the seven patients with angiosarcoma from whom tumor-free portions of the liver were available, and in two tumor-free biopsies from patients subsequently found to have angiosarcoma. The fibrosis was accompanied by splenomegaly. Hypertrophy and hyperplasia of both hepatocytes and hepatic and splenic mesenchymal cells were also seen. The histologic similarity to chronic inorganic arsenical poisoning, in which angiosarcomas also occur, and to idiopathic portal hypertension (Banti's syndrome) suggests that the latter syndrome at times results from unknown toxic, possible environmental, chemicals.