Discipline of Medicine, Pengiran Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Bandar Seri Begawan, Brunei.
Department of Pathology, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei.
Acta Cytol. 2021;65(6):478-482. doi: 10.1159/000518453. Epub 2021 Aug 31.
Paraffin injections for breast augmentation once a popular form of mammoplasty are now considered obsolete. It had been abandoned by clinicians because of its associated serious complications. The practice is however still available and is being practiced by nonmedically qualified people. Paraffin injection results in the formation of multiple foreign-body granulomas known as breast paraffinoma. The clinical features of breast paraffinoma can mimic and be mistaken for breast carcinoma or inflammatory breast carcinoma. The use of fine-needle aspiration cytology (FNAC) in the evaluation of patients with breast paraffinoma has not been fully evaluated.
Retrospective review was performed on 30 patients who presented with breast paraffinoma between June 1, 2010, and June 30, 2020, who also had FNAC as part of their breast lump evaluation.
FNAC of 73.3% patients showed multinucleated giant cells and macrophages or histiocytes containing engulfed clear, empty intracytoplasmic vacuoles of varying sizes. In 13.3% of the patients, macrophages or histiocytes with engulfed clear intracytoplasmic vacuoles of varying sizes were seen. In 6.7% of patients, multinucleated giant cells containing engulfed vacuoles of varying sizes were seen, and in 6.7% of patients, hypocellular smears with large amount of clear spaces were seen. Oily droplets were seen in the background of all the smears, and there were no malignant cells seen. These features were compatible with breast paraffinoma.
Most patients with breast paraffinoma can be managed conservatively and they do not require further treatment; FNAC with its characteristic features can provide the reliable diagnosis of breast paraffinoma and therefore sparing these patients from more invasive diagnostic procedures.
石蜡注射隆胸曾经是一种流行的隆乳术，但现在已被认为过时。由于其相关的严重并发症，已被临床医生摒弃。然而，这种做法仍然存在，并被非医学专业人员实施。石蜡注射会导致形成多个异物肉芽肿，称为乳房石蜡瘤。乳房石蜡瘤的临床特征可模仿并误诊为乳腺癌或炎性乳腺癌。细针抽吸细胞学（FNAC）在评估乳房石蜡瘤患者中的应用尚未得到充分评估。
回顾性分析了 2010 年 6 月 1 日至 2020 年 6 月 30 日期间就诊的 30 例乳房石蜡瘤患者，这些患者也接受了 FNAC 检查，作为其乳房肿块评估的一部分。
73.3%的患者的 FNAC 显示多核巨细胞和巨噬细胞或组织细胞，其中含有大小不一的吞噬性清晰、空的细胞内空泡。在 13.3%的患者中，可见吞噬性大小不一的清晰细胞内空泡的巨噬细胞或组织细胞。在 6.7%的患者中，可见含有大小不一吞噬性空泡的多核巨细胞，在 6.7%的患者中，可见细胞稀少的涂片，其中有大量的清晰空间。所有涂片的背景中都可见油滴，未见恶性细胞。这些特征与乳房石蜡瘤相符。
大多数乳房石蜡瘤患者可以保守治疗，不需要进一步治疗；FNAC 具有其特征性表现，可以提供可靠的乳房石蜡瘤诊断，从而使这些患者避免更具侵袭性的诊断程序。
