Fine Needle Aspiration Appearances of Silicone Lymphadenopathy

Background: Silicone breast implants are widely used for breast augmentation and reconstruction post mastectomy. Nodal pathology associated with silicone implant rupture is not well known and the fine needle aspiration (FNA) appearances of silicone lymphadenopathy are even less well described.
Case Report: FNA appearances of an axillary lymph node from a 64 year old woman with known ruptured silicone implant of 6 year duration is described and the findings are compared with the histological appearances of silicone lymphadenopathy due to ruptured silicone implant from a 59 year old woman with a similar history. The cytological preparations showed foamy macrophages and multinucleated giant cells in a background of benign lymphoid cells. No refractile or birefringent foreign material was observed. No epithelial or lymphoid malignancy was detected. The tissue sections were extensively infiltrated by foamy macrophages with small numbers of multinucleated giant cells. The latter also showed cytoplasmic vacuolation. No refractile material, epithelial or lymphoid malignancy was detected.
Conclusions: Silicone-induced lymphadenopathy can be confused with metastatic breast cancer and awareness of the condition can avoid erroneous interpretation.

Keywords: Breast Implants, Lymph Nodes, Silicone Gels