Holy House School of Medicine, São Paulo, Brazil.
Brazilian Cancer Control Institute, Brazil.
J Immunol Res. 2018 Sep 20;2018:6784971. doi: 10.1155/2018/6784971. eCollection 2018.
Currently, attention has been given to complications related to breast implants, especially due to the presence of anaplastic large cell lymphoma (ALCL) related to silicone implants. Many manuscripts attempt to associate silicone presence with clinical complaints reported by patients, while others try to demonstrate the mechanisms of silicone bleeding by permeability loss of breast implant surfaces. There also are reports of foreign body type reactions from implant fibrous capsule to silicone corpuscles. However, there seems to be no study that correlates the clinical, radiological, and histological correlations of these lesions. The objective of this review is to correlate radiological findings of silicone-induced granuloma of breast implant capsule (SIGBIC) from breast MRI (BMRI) scans and complementary findings of ultrasound (US) and positron emission tomography (PET) scan, and its histology originated from surgical breast implant capsulectomy. To make this correlation possible, we divided SIGBIC into three radiological findings: (1) intracapsular SIGBIC, (2) SIGBIC with extracapsular extension, and (3) mixed SIGBIC associated with seroma. Our experience demonstrates histological-radiological correlation in SIGBIC diagnosis. Knowledge of these findings may demonstrate its real importance in terms of public health and patient management. We believe that SIGBIC is currently underdiagnosed by lack of training, guidance, and management in our clinical practice.
目前,人们已经关注到与乳房植入物相关的并发症,特别是与硅胶植入物相关的间变性大细胞淋巴瘤 (ALCL)。许多文献试图将硅胶的存在与患者报告的临床症状联系起来,而另一些文献则试图通过乳房植入物表面的通透性丧失来证明硅胶出血的机制。也有报道称,来自植入纤维囊的异物型反应会导致硅胶小体。然而,似乎没有研究将这些病变的临床、放射学和组织学相关性进行关联。本综述的目的是将乳房 MRI (BMRI) 扫描中硅胶诱导的乳房植入物胶囊肉芽肿 (SIGBIC) 的放射学发现与超声 (US) 和正电子发射断层扫描 (PET) 扫描的补充发现及其源自乳房植入物囊切除术的组织学联系起来。为了实现这种相关性,我们将 SIGBIC 分为三种放射学发现:(1) 囊内 SIGBIC,(2) 囊外扩展的 SIGBIC,和 (3) 与血清肿相关的混合 SIGBIC。我们的经验表明,SIGBIC 的组织学-放射学相关性在诊断中是可行的。了解这些发现可能会证明它们在公共卫生和患者管理方面的真正重要性。我们认为,由于缺乏培训、指导和管理,SIGBIC 在我们的临床实践中被漏诊了。