The Effect of Single Massive Doses of Roentgen Radiation Upon the Liver

The effects of radiation upon the liver have been extensively investigated, but contradictory findings are reported. This study presents an analysis of the acute morphologic alterations which may occur in the rabbit's liver following single massive doses of roentgen radiation to that organ. Doses of 300 to 100,000 r were given and the animals were sacrificed or succumbed at various intervals thereafter. Observations on the histopathologic changes in the liver following roentgen irradiation have been made by several workers. Hall and Whipple (3), Martin and Rogers (6), Warren and Whipple (13–16), have reported absence of histologic change in the liver following deep roentgen therapy. Pohle and Bunting (9) described an alteration after doses of 600 to 2,500 r, manifested by an initial swelling of the hepatic cells with subsequent atrophy following recovery. They believed the swelling to be due to an imbibition of serum and occasionally of fat. Case and Warthin (1) described three human cases in which there was extensive damage to the liver following intensive irradiation for malignant disease. They expressed the belief that the medium-sized and small bile ducts are sensitive, as shown by vacuolization, swelling, and necrosis of the epithelial cells followed by a slow and atypical regeneration attended by the formation of syncytial giant cells blocking the ducts, with consequent bile stasis and hemorrhage. Some injury to the liver cells was noted, essentially at the periphery of the lobules. Hartoch and Israelski (4) studied the effects of 1,000 to 4,000 r (180 kv., 1.0 mm. Al and 2.0 mm. Cu filter) on summer frogs. With a fluorescent microscope, they observed an actual shrinkage of the bile capillaries following high dosages. Lüdin (5) reported evidence of nuclear damage in the livers of rabbits receiving large doses of filtered radiation. Smythe and Whipple (11), by means of bile fistula experiments, demonstrated rapid recovery from the liver damage resulting from irradiation. Doub, Bolliger, and Hartman (2) observed that following fractional doses of irradiation to dogs some animals showed a reduction of 50 per cent in the weight of the liver, extensive fatty infiltration, areas of focal necrosis, some increase of fibrous tissue at the periphery of the lobule, loss of the orderly cell arrangement, and extensive regeneration. Reports have also been presented describing the effect of intravenously injected thorium dioxide upon the liver. Pohle and Ritchie (10) noted hydropic degeneration, edema of the portal spaces, and dilatation of the periportal lymphatics, with subsequent slight atrophy of liver cells and fibrosis of portal spaces. Similar reports have been made by Orr et al. (7) and by Patoir and Bedrine (8). The contradictory observations on the histologic alterations of the liver resulting from roentgen irradiation are probably due to differences in dosage and in the type of radiation administered.