Chung Kyung Young, Kim Se Hoon, Kwon Il Hoon, Choi Young Sik, Noh Tae Woong, Kwon Tae Jung, Shin Dong Hwan
Department of Pathology, Yonsei University College of Medicine, C.P.O. Box 8044, Seoul 120-752, Korea.
Yonsei Med J. 2002 Apr;43(2):152-9. doi: 10.3349/ymj.2002.43.2.152.
It is known that the subcutaneous injection of silicone can lead to severe pulmonary complications, followed in some patients by respiratory failure. Currently, silicone is being increasingly applied in the field of plastic surgery and, unfortunately, the illicit injection of silicone fluid by uncertified practitioners is not uncommon in Korea. We offer a critical pathologic review of 5 cases of pulmonary silicone embolism following illegal injection to the vaginal wall, four of which were fatal and came to legal autopsy. Our findings again confirm that subcutaneously injected silicone can gain access to the pulmonary vascular tree and cause pulmonary embolism. The histologic changes observed in the lung are variable and include four patterns i.e., the mere presence of silicone emboli, congestion and hemorrhage, acute pneumonitis, and diffuse alveolar damage despite the severe critical course in all cases. We were unable to find any histologic pattern that correlates well with the clinical course. Apart from producing emboli in the pulmonary vessels, subcutaneous injection of silicone can obviously cause serious pulmonary disease due to its ability to induce acute to induce acute pneumonitis and even possibly acute respiratory distress syndrome.
众所周知，皮下注射硅胶可导致严重的肺部并发症，部分患者随后会出现呼吸衰竭。目前，硅胶在整形手术领域的应用越来越广泛，不幸的是，在韩国，未经认证的从业者非法注射硅胶液体的情况并不少见。我们对5例阴道壁非法注射后发生肺硅栓塞的病例进行了批判性病理回顾，其中4例死亡并进行了法定尸检。我们的研究结果再次证实，皮下注射的硅胶可进入肺血管系统并导致肺栓塞。在肺中观察到的组织学变化各不相同，包括四种模式，即仅存在硅栓、充血和出血、急性肺炎以及弥漫性肺泡损伤，尽管所有病例的病情都很严重。我们未能找到任何与临床病程密切相关的组织学模式。除了在肺血管中产生栓子外，皮下注射硅胶显然还会因其诱发急性肺炎甚至可能诱发急性呼吸窘迫综合征的能力而导致严重的肺部疾病。
