Borghol K, Gallagher G, Skelly B L
Northern Health and Social Care Trust , UK.
Ann R Coll Surg Engl. 2016 Sep;98(7):e118-20. doi: 10.1308/rcsann.2016.0166. Epub 2016 May 11.
A 56-year-old woman with a 10-year history of bilateral silicone breast implants presented to the ear, nose and throat outpatient clinic with a 2-month history of a right-sided neck lump. She was found to have a 1.3cm supraclavicular lymph node that gave the clinical impression of being reactive. Ultrasonography guided fine needle aspiration was inconclusive and initial review of subsequent computed tomography failed to identify a cause. This was followed by excisional biopsy of the lymph node, which revealed a silicone granuloma that was linked to a ruptured right-sided breast implant placed ten years previously. This case highlights the importance for otolaryngologists to consider silicone granuloma among the differential diagnoses of cervical lymphadenopathy in patients with a history of silicone breast implants. Recognising this differential diagnosis could avoid undue anxiety for patient and clinician regarding more serious pathology.
一名有双侧硅胶乳房植入物10年病史的56岁女性前往耳鼻喉科门诊就诊,有右侧颈部肿块2个月的病史。发现她有一个1.3厘米的锁骨上淋巴结,临床印象为反应性。超声引导下细针穿刺结果不明确,随后对计算机断层扫描的初步检查未能找出病因。随后对该淋巴结进行了切除活检,结果显示为硅胶肉芽肿,与十年前植入的右侧破裂乳房植入物有关。该病例强调了耳鼻喉科医生在有硅胶乳房植入物病史的患者颈部淋巴结病鉴别诊断中考虑硅胶肉芽肿的重要性。认识到这种鉴别诊断可以避免患者和临床医生对更严重病变产生不必要的焦虑。