The pathology of multi-organ involvement: two autopsy cases from the Tokai-mura criticality accident

We briefly report the pathological findings of two victims of the Tokai-mura criticality accident. Patients A and B were exposed to 17–24 Gy Eq and 8–12 Gy Eq, respectively. They received initial and intensive treatments, including blood transplantation and skin grafting, but both died, on day 82 and day 210, respectively. In Patient A the skin showed wide ulcerations on the anterior side of the whole body. The alimentary tract showed almost total loss of the epithelium. Other findings included hypocellular bone marrow with donor chimerism, oedema and congestion of the lungs without fibrosis, and markedly degenerated skeletal muscles. The skin of Patient B showed fibrosis and atrophy on the anterior side. His small intestine had segmental erosions caused by thrombotic microangiopathy (TMA). The bone marrow showed autologous recovery but remained hypocellular. His muscles showed degeneration, especially in the anterior sections. Pneumonia made it difficult to determine the radiation injury. These cases had...