Document OEo1y1xmxBDo9bYoo4bjag861
tc;:i!^AL RECORD
'."L'CIMEN SUBMITTED BV
John Veirling, M.D.
S' LCI MEN
Outside liver biopsy slides
TISSUE EXAMINATION
DATE OBTAINED
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HRlEF CLINICAL HISTORY (Jndud* 4uriiii of Ution %nd rupidUw of grvmlk, if a ntopiaam)
43 year old male with two year exposure to vinyl chloride.
Biopsy thru hepatic vein
__ (See our S74-1853)____________________________________________________
. < = OPERATIVE DIAGNOSIS
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OPERATIVE FINDINGS
POSTOPERATIVE DIAGNOSIS
SIGNATURE AND TITLE
NAME OF LABORATORY
PATHOLOGICAL REPORT
| ACCESSION NO(S).
Surgical Patholoev Section
i Groat dtacrijston. hutoipfif ammaiiM mnd rfiipwal
__________________ S74-19Q2________________
Gross;
The specimen consists of 1 submitted slide bearing the. label of St. Anthony Hospital, Louisville, Kentucky and the accession number 574-2753.
Microscopic;
The section.includes several fragments of hepatic tissue which includes portions of two small portal tracts. These are infiltrated by a few lymphocytes- There is mild fatty vacuolization of hepatic cells but otherwise the hepatic lobules, hepatocytes and sinusoidal cells all appear normal. Slight focal variation in staining is thought possibly to represent artefact.
Diagnosis;
1. Mild fatty metamorphosis, liver.
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| AGE ! 43
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Submitted by: St. Anthony Hospital Louisville, Kentucky
1 DATE
( RACE !w
! 8/21/74 1 IDENTIFICATION NO. 1
REGISTER NO.
10-35-16-2
| WARD NO.
TISSUE EXAMINATION
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BFG67296
Note: ...The submitted section included in this report was reviewed by Dr. Popper who concurs with the diagnosis o mild fatty change. At the same time, liver sections previously reported under our accession no. S74-1S53 were also reviewed and discussed with Dr. Paul Berk.
The conclusions from this review and discussion can be summarized as follows:
(1) The moderate portal tract and focal intralobular fibrosis seen in S74-1853 are not soecific; i.e., they may be due to alcohol damage to the liver bvcC some other type of chemical injury cannot be ruled out.
(2) Certain features which seem to be characteristic of the liver changes in vinyl chloride polymerization workers are absent in llr. Kennedy's liver. These are: (a) no- fibrosis of the hepatic capsule; (b) no proliferation or enlargement of sinusoidal and lining cells; (c) no sinusoidal dilatation; (d) no enlargement (megalocytosis) of hepatocytes.
(3) The amount and the distribution of the hepatic fibrosis seen in the S74-1853 sections (biopsy obtained by peritoneoscopy) do not appear to be sufficient to explain the splenomegaly. It is theoretically possible that the hepatic fibrosis and the enlargement of the spleen have different etiologies. Whether the patient actually has portal hypertension and whether the splenomegaly is a result of hepatic lesions is not known at the present time.
# Robert Stern, M.D.
BFG67297