Lymph nodes & spleen, nonlymphoma
Lymph nodes-inclusions, pigment, ectopic cells or tissue
Silicone


Topic Completed: 1 August 2014

Minor changes: 4 November 2020

Copyright: 2003-2020, PathologyOutlines.com, Inc.

PubMed Search: Silicone [title] lymph nodes


Jayalakshmi Balakrishna, M.D.
Abdelsalam Sharabi, M.D.
Page views in 2019: 3,248
Page views in 2020 to date: 2,810
Cite this page: Balakrishna J, Sharabi A. Silicone. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/lymphnodessiliconeimplant.html. Accessed November 25th, 2020.
Definition / general
  • Rare enlargement of regional lymph nodes caused by the presence of silicone carried from tributary organs
  • Either an incidental finding or causes painful / enlarged lymph node
  • May be associated with granulomatous inflammation (Histol Histopathol 1997;12:1003)
Terminology
  • Silicone lymphadenopathy
Sites
Pathophysiology
  • Silicone is widely used in implants, especially augmentation mammoplasty and joint prostheses (Hum Pathol 1980;11:240)
  • Once released into tissue, silicone migrates to distant sites through lymphatic channels and bloodstream
  • Once it reaches lymph nodes, it elicits a reaction and cause silicone lymphadenopathy
Etiology
  • Rupture / leak of the implant, or implant 'bleeds', or releases microparticles into blood / lymphatics
Clinical features
  • Enlarged lymph nodes
  • Asymptomatic or with pain
Diagnosis
  • Biopsy
Radiology description
  • Ultrasonogram: hyperechoeic (increased echogenicity of the lymph node mediastinum with dirty acoustic shadowing), beginning in the hilum and progressing outward through the cortex with time and amount of silicone
  • In severe cases, snowstorm appearance
Prognostic factors
  • Depends upon the amount of silicone and severity of the reaction
Case reports
Treatment
  • Removal of lymph nodes
Clinical images

Images hosted on other servers:

Rupture of implant

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Various images

Gross description
  • No specific gross features
  • Enlarged and firmer than normal
  • Extreme cases show distorted architecture and fibrosis
Gross images

Images hosted on other servers:

Calcified silicone capsule

Microscopic (histologic) description
  • Diffuse follicular hyperplasia
  • Histiocytes with vacuolated cytoplasm especially inside the sinusoids
  • Histiocytes cause foreign body granulomatous reaction, giant cells and empty vacuoles
  • Giant cells have refractile and non-birefringent particles
  • Asteroid bodies may be seen
  • Silicone from orthopedic devices: prominent granulomatous reaction with clumps of granular yellowish refractile material
  • Silicone from mammary prostheses: finer vacuolated deposits
Microscopic (histologic) images

Contributed by Dr. Mark R. Wick

Silicone in axillary lymph node



Images hosted on other servers:

Material consistent with silicone

Liquid silicone droplets

Missing Image

Various images

Subcapsular sinus diffusely expanded

Vacuoles which contain refractile material

Missing Image

Foreign body granuloma


Germinal centers surrounded by sinuses

Silicone leakage

Silicone particles in cystic spaces

Cytology description
  • Numerous multi-vacuolated histiocytic cells both scattered individually as well as in aggregates
  • Contain clear, refractile but non-polarizable material
  • Background may show scattered lymphocytes
Positive stains
Negative stains
Electron microscopy description
  • Electron opaque fragmented spicules or flakes
Differential diagnosis
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