Silicone Lymphadenopathy : Pathogenesis
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Introduction: Silicone lymphadenopathy is seen in the regional lymph nodes following leakage of silicone, usually from an implant placed in the drainage area. In women with silicone breast implants, axillary lymph nodes show histologic evidence of silicone in almost 90% of cases.
Pathogenesis: Silicone is a polymer of dimethylsiloxane. Short chain polymers are in liquid state. Long chain polymers form gels. Cross-linking of long chains creates silicone rubber. Silicone is a stable, inert, and a non-biodegradable material. When placed in human tissues, it causes no reaction to variable foreign body inflammatory response. It has been used extensively in implants for reconstructive, orthopedic, and cosmetic procedures. One of the most common uses of silicone has been in breast implants, both for cosmetic breast augmentation as well as breast reconstruction after mastectomy.
Over time, silicone implants may rupture or leak or just slowly ooze silicone particles from an intact surface. The silicone particles reach the regional lymph nodes via lymphatics where they induce a reaction referred to as silicone lymphadenopathy. Silicone particles can migrate to distant locations within the body via lymphatics and blood vessels as well as simply by gravity.
Image credit: U.S. Food & Drug Administration website; accessed Feb. 4, 2020.
Pathogenesis: Silicone is a polymer of dimethylsiloxane. Short chain polymers are in liquid state. Long chain polymers form gels. Cross-linking of long chains creates silicone rubber. Silicone is a stable, inert, and a non-biodegradable material. When placed in human tissues, it causes no reaction to variable foreign body inflammatory response. It has been used extensively in implants for reconstructive, orthopedic, and cosmetic procedures. One of the most common uses of silicone has been in breast implants, both for cosmetic breast augmentation as well as breast reconstruction after mastectomy.
Over time, silicone implants may rupture or leak or just slowly ooze silicone particles from an intact surface. The silicone particles reach the regional lymph nodes via lymphatics where they induce a reaction referred to as silicone lymphadenopathy. Silicone particles can migrate to distant locations within the body via lymphatics and blood vessels as well as simply by gravity.
Image credit: U.S. Food & Drug Administration website; accessed Feb. 4, 2020.