Pathology of lymph nodes from patients with breast implants: a histologic and spectroscopic evaluation.

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Pathology of lymph nodes from patients with breast implants: a

histologic and spectroscopic evaluation.

Katzin WE, Centeno JA, Feng LJ, Kiley M, Mullick FG.

Departments of Pathology, Case Western Reserve University School of

Medicine, Cleveland, OH, USA. wkatzin@...

There are only a few published reports describing the pathology of

regional lymph nodes from patients with silicone breast implants.

Systematic analytical chemical verification of foreign material has

not previously been reported. In this study, biopsies of regional

lymph nodes from 96 patients with breast implants were studied using

conventional histology as well as laser-Raman microprobe spectroscopy

and Fourier transform infrared microspectroscopy. Lymph nodes from 12

patients without implants served as negative controls. Foamy

macrophages, ranging from rare scattered cells to confluent sheets,

were observed in sections of lymph nodes from 91 patients with

implants and only rare foamy macrophages were observed in sections

from 4 patients without implants. Refractile material consistent with

silicone was observed in sections from 86 patients with implants and

in no sections from patients without implants. Fragments of foreign

material consistent with polyurethane were observed in sections from

16 patients with implants and in no sections from patients without

implants. Using spectroscopy, the presence of silicone was confirmed

in 71 patients with implants, and the presence of polyurethane was

confirmed in 2 patients with implants. Spectroscopy was negative for

silicone and polyurethane in all patients without implants. In

summary, regional lymph nodes from patients with breast implants

often have histologic evidence of silicone migration. Characteristic

histologic findings include foamy macrophages and refractile droplets

of clear material. Polygonal fragments of polyurethane were observed

in lymph nodes from a number of patients. This finding has not been

previously reported. The presence of silicone and polyurethane was

confirmed using confocal laser-Raman microprobe and Fourier transform

infrared microspectroscopy. Other than two prior case reports, this

is the first confirmatory evidence of silicone migration to lymph

nodes in patients with breast implants and this is the first

confirmatory report of polyurethane migration to lymph nodes.

PMID: 15767806 [PubMed - indexed for MEDLINE]

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