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Lung fibrosis induced by Thorotrast
P De Vuyst1, P Dumortier, P Ketelbant
1Chest Department, Erasme Hospital, Free University of Brussels, Belgium.
Thorax
|November 1, 1990
Summary
Thorotrast, a radioactive contrast agent, caused fatal pulmonary fibrosis and respiratory failure in a patient 45 years after exposure. This rare complication highlights the long-term risks of thorium dioxide in medical imaging.
Area of Science:
- Radiology
- Pulmonary Medicine
- Toxicology
Background:
- Thorotrast (thorium dioxide) was historically used as a contrast agent in medical imaging.
- Long-term adverse effects, particularly in the lungs, are rarely reported.
- This case investigates a delayed pulmonary complication following Thorotrast administration.
Observation:
- A 63-year-old woman presented with progressive dyspnea, pulmonary hypertension, and respiratory failure.
- She had a history of thoracic fistulography using Thorotrast 45 years prior.
- Recurrent episodes of noncardiogenic pulmonary edema were noted.
Findings:
- Autopsy and biopsy revealed abundant thorium dioxide particles in the lung tissue.
- Radioactive particles were concentrated in vessel walls and perivascular areas.
- Histopathology showed significant lung fibrosis, consistent with Thorotrast-induced pathology.
Implications:
- Thorotrast exposure can lead to severe, long-latency pulmonary fibrosis.
- The mechanism likely involves chronic alpha radiation and endothelial damage.
- This case underscores the importance of considering historical contrast agent use in diagnosing rare lung diseases.