Klang Eyal, Amitai Michal M, Raskin Stephen, Rozendorn Noa, Keddel Nicholas, Pickovsky Jana, Sklair-Levy Miri
Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel.
Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Isr Med Assoc J. 2016 Dec;18(12):719-724.
Silicone breast augmentation is a common cosmetic surgery. Previous case reports demonstrated lymphadenopathy in the presence of implant ruptures.
To investigate the association between enlarged axillary lymph nodes and silicone implant ruptures as seen on breast magnetic resonance imaging (MRI).
Two groups were derived retrospectively from breast MRI reports in our institution for the period December 2011-May 2014. A search of our hospital records for "silicone" and "lymph node" was performed (group A), and the relationship between the presence of enlarged nodes and ruptures was evaluated. The prevalence of ruptures in the presence of nodes was calculated and the association between MRI imaging features and ruptures evaluated. A search for "silicone" and "implant rupture" was performed (group B) and, as for group A, the relationship between the presence of ruptures and nodes was evaluated and the prevalence of enlarged nodes in the presence of ruptures calculated.
Group A comprised 45 women with enlarged nodes. Intracapsular ruptures were associated with nodes (P = 0.005), while extracapsular ruptures showed a trend of association with nodes (P = 0.08). The prevalence of ruptures in the presence of nodes was 31.4%. Nodes associated with ruptures showed a strong silicone signal (P = 0.008) and absent enhancement (P = 0.005). Group B comprised 73 women with ruptures. Enlarged nodes were associated with both intra- and extracapsular ruptures (P < 0.001 and P = 0.002 respectively). The prevalence of nodes in the presence of ruptures was 22.2%.
Enlarged axillary nodes were associated with ruptures in two groups of patients. This finding can guide clinical decisions when either enlarged nodes or ruptures are encountered in patients with silicone implants. The association between silicone lymphadenopathy and implant rupture raises concerns regarding the role of rupture in silicone-induced systemic disease.
硅胶隆胸是一种常见的整形手术。既往病例报告显示，植入物破裂时会出现淋巴结病。
研究乳腺磁共振成像（MRI）显示的腋窝淋巴结肿大与硅胶植入物破裂之间的关联。
回顾性选取2011年12月至2014年5月期间本院乳腺MRI报告中的两组病例。在本院记录中搜索“硅胶”和“淋巴结”（A组），评估肿大淋巴结的存在与破裂之间的关系。计算有淋巴结时破裂的发生率，并评估MRI成像特征与破裂之间的关联。搜索“硅胶”和“植入物破裂”（B组），与A组一样，评估破裂的存在与淋巴结之间的关系，并计算有破裂时肿大淋巴结的发生率。
A组包括45例淋巴结肿大的女性。囊内破裂与淋巴结有关（P = 0.005），而囊外破裂与淋巴结有相关趋势（P = 0.08）。有淋巴结时破裂的发生率为31.4%。与破裂相关的淋巴结显示出强烈的硅胶信号（P = 0.008）且无强化（P = 故0.005）。B组包括73例有破裂的女性。肿大淋巴结与囊内和囊外破裂均有关（分别为P < 0.001和P = 0.002）。有破裂时淋巴结的发生率为22.2%。
两组患者中，腋窝淋巴结肿大均与破裂有关。这一发现可为硅胶植入患者出现肿大淋巴结或破裂时的临床决策提供指导。硅胶淋巴结病与植入物破裂之间的关联引发了人们对破裂在硅胶诱导的全身性疾病中作用的关注。
