Silicone Granuloma

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Silicone Granuloma (Siliconoma) ,

http://www.histopathology-india.net/SiGr.htm

Silicone oil, gels and rubber are bioactive agents that may induce host reactions.Silicones are easily detected in tissue as small round to irregular droplets of amorphous refractile non-polarising material. Thick sections (10-30 micrometer thick) prevent loss of silicone droplets during tissue processing.

The silicones can be detected by adding stamp pad ink to the mounting medium. Non-Koehler, phase contrast & darkfield microscopy help to highlight the silicones.

Granuloma as a reaction to silicone is mainly found after extracellular rupture of an implant and after injections with silicones.

These granulomas may present as a tumour some distance from the implant.

Visit: FOREIGN BODY GRANULOMA OF SKIN

Microscopic patterns :

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In case of injection with liquid silicone - There are numerous cystic spaces and vacuoles partly filled with silicones surrounded by a thin layer of fibrous tissue Foreign body giant cell reaction is minimal.

In case of extracapsular rupture - There are many giant cells of the foreign body type often containing silicones and foam cells together with lymphocytes.

Silicone granuloma.Dermatology. 2000;200(4):360-2.

Pathology of silicone leakage from breast implants.J Clin Pathol. 1998 Jul;51(7):493-7.

Histologic features of breast capsules reflect surface configuration and composition of silicone bag implants.Am J Clin Pathol. 1994 Nov;102(5):655-9.

Light microscopy techniques for the demonstration of silicone gel.Arch Pathol Lab Med. 1994 Oct;118(10):984-7.

Histologic changes and silicone concentrations in human breast tissue surrounding silicone breast prostheses.Plast Reconstr Surg. 1990 Jan;85(1):38-41.

Silicone granulomas: report of three cases and review of the literature.Hum Pathol. 1985 Jan;16(1):19-27.

Silicone granulomas: report of three cases and review of the literature.

WD, Balogh K, Abraham JL.

Since silicone is rapidly becoming one of the most commonly used biomaterials in modern medicine, pathologists will be observing increasing numbers of cases of silicone-related disease. Although numerous case reports have established that silicone elicits a characteristic response in tissues, the varying tissue reactions to silicone gels, liquids, and elastomers (rubber) have not been emphasized. Three cases are reported, and the literature is reviewed to illustrate the varying features of tissue reaction to silicone in its different forms. The first case is an example of silicone lymphadenopathy in an inguinal lymph node. This case demonstrates exuberant foreign body granuloma formation in response to particles of silicone elastomer. The second case involves a patient who had facial subcutaneous liquid silicone injections, and the third case is that of a woman in whom breast carcinoma developed 13 years after mammary augmentation with liquid silicone injections. These two cases illustrate the characteristic reaction to silicone liquid, with numerous cystic spaces and vacuoles in the soft tissues but minimal or no foreign body giant cell reaction. Scanning electron microscopy and energy dispersive x-ray analysis were performed in the first two cases, confirming the presence of silicon. Silicone migration and the clinical significance of various silicone-induced lesions are discussed.PMID: 3882545 [PubMed - indexed for MEDLINE]

http://www.ncbi.nlm.nih.gov/pubmed/3882545?ordinalpos=2 & itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

Silicone granulomas: report of three cases and rev...[Hum Pathol. 1985] - PubMed Result

Silicone lymphadenopathy associated with failed prosthesis of the hallux: a case report and literature review. [Foot Ankle. 1992]

Silicone lymphadenopathy: a complication of silicone elastomer finger joint prostheses. [Hum Pathol. 1980]

Silicone lymphadenopathy associated with augmentation mammaplasty. Morphologic features of nine cases. [Am J Surg Pathol. 1988]

Silicone granuloma. [Dermatology. 2000]

Axillary lymphadenopathy 17 years after digital silicone implants: study with x-ray microanalysis. [J Hand Surg [Am]. 1988]

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