Silicone leak / lymphadenopathy

Topic Completed: 1 April 2010

Minor changes: 17 November 2020

Copyright:: 2002-2020,, Inc.

PubMed Search: Silicone breast implants [title]

Hind Warzecha, M.D.
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Page views in 2020 to date: 4,706
Cite this page: Warzecha H. Silicone leak / lymphadenopathy. website. Accessed November 23rd, 2020.
Definition / general
  • Important to document gross and histologic findings associated with implant related specimens
  • Axilla:
    • Due to silicone prosthesis or migration of injected silicone
    • Either an incidental finding or causes painful / enlarged lymph node
Etiology - Axilla
Clinical features
Case reports
Microscopic (histologic) description
  • Chronic inflammatory response (plasma cells, B and T cells and foamy macrophages) with fibrotic capsule around the implant causing contracture of prosthesis (Aesthetic Plast Surg 2010;34:481)
  • Lining cells may resemble synovium (synovial metaplasia, Mod Pathol 1994;7:310)
  • Gel may seep through intact implant shells
  • May have foreign body reaction with sinus tracts
  • Numerous cystic spaces and vacuoles may exist where silicone dissolves during processing
  • Axilla:
Microscopic (histologic) images

Contributed by Andrey Bychkov, M.D., Ph.D.

Giant cell reaction

AFIP images

Refractile silicone and giant cell reaction (arrow at doubly refractile silicone)

Silicone globules,
giant cell
reaction, fibrosis

Polyurethane implant -
polyurethane (arrow)
and silicone
(round globules)

Images hosted on other servers:

Silicone globules, giant cell inflammatory reaction, fibrosis

Capsular synovial metaplasia

Foreign body reaction to silicone


histiocytes expand
subcapsular sinus

Multinucleated giant cells contain refractile material

Silicone lymphadenopathy

Cytology description - Axilla
Differential diagnosis - Axilla
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