Collado-Mesa Fernando, Yepes Monica, Doshi Purvi, Umar Saleem A, Net Jose
Department of Radiology, University of Miami Miller School of Medicine, Miami, FL, USA.
Department of Pathology, University of Miami Miller School of Medicine, Miami, FL, USA.
J Radiol Case Rep. 2013 Nov 1;7(11):24-31. doi: 10.3941/jrcr.v7i11.1562. eCollection 2013 Nov.
Silicone lymphadenopathy is a recognized complication of silicone gel implant rupture; the ipsilateral axillary lymph nodes are most commonly involved. We report imaging findings on a range of different imaging modalities and biopsy results in a case of biopsy-proven silicone lymphadenitis involving contralateral intramammary and axillary lymph nodes in a patient with an intact standard dual-lumen breast implant in the opposite reconstructed breast. This case demonstrates that in a patient with disrupted lymph drainage due to prior mastectomy and axillary node dissection for breast cancer treatment, silicone particles can migrate in a retrograde fashion via the ipsilateral internal mammary lymph nodes and reach not only the contralateral axilla but also the outer quadrants of the contralateral breast, even in the presence of an intact breast implant.
硅胶性淋巴结病是硅胶凝胶植入物破裂的一种公认并发症;同侧腋窝淋巴结最常受累。我们报告了一例经活检证实的硅胶性淋巴结炎患者的一系列不同成像模态的影像学表现及活检结果,该患者对侧重建乳房中有一个完整的标准双腔乳房植入物,而硅胶性淋巴结炎累及对侧乳腺内及腋窝淋巴结。该病例表明,对于因先前乳腺癌治疗行乳房切除术和腋窝淋巴结清扫而导致淋巴引流中断的患者,即使存在完整的乳房植入物,硅胶颗粒也可通过同侧内乳淋巴结逆行迁移,不仅可到达对侧腋窝,还可到达对侧乳房的外象限。