A Case of Silicone and Sarcoid Granulomas in a Patient with “Highly Cohesive” Silicone Breast Implants: A Histopathologic and Laser Raman Microprobe Analysis

Todor I. Todorov, Erik de Bakker, Diane Smith, Lisette C. Langenberg, Linda A. Murakata, Mark H. H. Kramer, Jose A. Centeno and Prabath W. B. Nanayakkara
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Todor I. Todorov: Department of Environmental and Infectious Disease Sciences, Division of Biophysical Toxicology, Armed Forces Institute of Pathology, Washington, DC 20306, USA
Erik de Bakker: Department of Plastic Surgery, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
Diane Smith: Henry Jackson Foundation, Bethesda, MD 20817, USA
Lisette C. Langenberg: Department of Internal Medicine, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
Linda A. Murakata: Department of Environmental and Infectious Disease Sciences, Division of Biophysical Toxicology, Armed Forces Institute of Pathology, Washington, DC 20306, USA
Mark H. H. Kramer: Department of Pathology, VU University Medical Centre, P.O. Box 7057, 1007 MB Amsterdam, The Netherlands
Jose A. Centeno: Department of Environmental and Infectious Disease Sciences, Division of Biophysical Toxicology, Armed Forces Institute of Pathology, Washington, DC 20306, USA
Prabath W. B. Nanayakkara: Henry Jackson Foundation, Bethesda, MD 20817, USA

IJERPH, 2021, vol. 18, issue 9, 1-11

Abstract: Foreign body giant cell (FBGC) reaction to silicone material in the lymph nodes of patients with silicone breast implants has been documented in the literature, with a number of case reports dating back to 1978. Many of these case reports describe histologic features of silicone lymphadenopathy in regional lymph nodes from patients with multiple sets of different types of implants, including single lumen smooth surface gel, single lumen textured surface gel, single lumen with polyethylene terephthalate patch, single lumen with polyurethane coating, and double lumen smooth surface. Only one other case report described a patient with highly-cohesive breast implants and silicone granulomas of the skin. In this article, we describe a patient with a clinical presentation of systemic sarcoidosis following highly cohesive breast implant placement. Histopathologic analysis and Confocal Laser Raman Microprobe (CLRM) examination were used to confirm the presence of silicone in the axillary lymph node and capsular tissues. This is the first report where chemical spectroscopic mapping has been used to establish and identify the coexistence of Schaumann bodies, consisting of calcium oxalate and calcium phosphate minerals, together with silicone implant material.

Keywords: breast implant; silicone; sarcoidosis; Raman; Schaumann bodies (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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