隆胸假体破裂继发肝硅肉芽肿：2例报告
Hepatic Silicone Granulomas Secondary to Ruptured Breast Implants: A Report of Two Cases.
作者信息
Hudacko Rachel, Anand Kapil, Gordon Ronald, John Tina, Catalano Carolyn, Zaldana Francisco, Katz Henry J, Fyfe Billie, Rustgi Vinod
机构信息
Department of Pathology and Laboratory Medicine, Rutgers Robert Wood Johnson Medical School, Medical Education Building Rm 212, One Robert Wood Johnson Place, New Brunswick, NJ 08903, USA.
Division of Gastroenterology and Hepatology, Department of Medicine, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building Suite 5100B, 125 Paterson St, New Brunswick, NJ 08901, USA.
出版信息
Case Reports Hepatol. 2019 Nov 3;2019:7348168. doi: 10.1155/2019/7348168. eCollection 2019.
The differential diagnosis of hepatic granulomas is vast and includes infections, drugs, immunologic diseases, foreign material exposure, and neoplasia. Silicone, whether directly injected into tissues or used as a filler in breast implants, is known to cause localized granulomatous reactions. It can also migrate to other anatomic locations resulting in granulomatous inflammation at a distance. We report two cases of unsuspected hepatic silicone granulomas in patients undergoing liver biopsy for isolated elevated alkaline phosphatase levels, both with a history of ruptured breast implants. These cases highlight the need for awareness of hepatic silicone granulomas as an etiology of elevated liver enzymes in patients with a history of surgical interventions utilizing silica, such as cosmetic surgery.
肝肉芽肿的鉴别诊断范围广泛，包括感染、药物、免疫性疾病、接触异物和肿瘤形成。已知硅胶，无论是直接注入组织还是用作乳房植入物的填充物，都会引起局部肉芽肿反应。它还可迁移至其他解剖部位，导致远处的肉芽肿性炎症。我们报告了两例在因孤立性碱性磷酸酶水平升高而接受肝活检的患者中意外发现的肝硅胶肉芽肿病例，这两名患者均有乳房植入物破裂史。这些病例强调了对于有使用硅胶的外科手术史（如整形手术）的患者，需要意识到肝硅胶肉芽肿可能是肝酶升高的一个病因。
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