Lázaro M A, García Morteo D, de Benyacar M A, Paira S O, Lema B, García Morteo O, Maldonado Cocco J A
Rheumatology Section, Instituto Nacional de Rehabilitación, Buenos Aires, Argentina.
Clin Exp Rheumatol. 1990 Jan-Feb;8(1):17-22.
The occurrence of lymphadenopathies was investigated in 23 patients with diverse rheumatic conditions who had silastic prosthesis in joints of the hands, to determine whether these adenopathies were due to the presence of silicone particles. Five cases had clinically detectable lymph node enlargement and tissue samples were studied by light and scanning electron microscopy (SEM) and energy dispersive X-ray analysis (EDXA). In 3 out of the 5 cases foreign body granulomas were observed by light microscopy, SEM showing a highly irregular distribution of foreign body material with a peak for silicone by EDXA. Foreign body particle distribution closely correlated with silicone concentration. No granulomas were found in the two remaining patients with adenopathies who presented a non-specific reactive lymphadenitis. Our findings show that silicone lymphadenopathy is a more frequent complication (13%) of silastic arthroplasty than is usually recognized and therefore should be considered in the differential diagnosis of patients with lymph node enlargement who have previously received a silicone arthroplasty.
对23例手部关节装有硅橡胶假体的不同风湿性疾病患者的淋巴结病发生情况进行了调查，以确定这些淋巴结病是否由硅颗粒的存在所致。5例有临床可检测到的淋巴结肿大，对其组织样本进行了光镜、扫描电子显微镜（SEM）和能量色散X射线分析（EDXA）研究。5例中有3例通过光镜观察到异物肉芽肿，SEM显示异物材料分布高度不规则，EDXA显示硅含量峰值。异物颗粒分布与硅浓度密切相关。其余2例有淋巴结病的患者未发现肉芽肿，表现为非特异性反应性淋巴结炎。我们的研究结果表明，硅橡胶淋巴结病是硅橡胶关节成形术比通常认识到的更常见的并发症（13%），因此在对先前接受过硅橡胶关节成形术且有淋巴结肿大的患者进行鉴别诊断时应予以考虑。
