Lai Y F, Chao T Y, Wong S L
Department of Internal Medicine, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Taiwan, Republic of China.
Chest. 1994 Oct;106(4):1152-5. doi: 10.1378/chest.106.4.1152.
In a period of 3 years, seven cases of acute pneumonitis have been found after patients have been subcutaneously injected with silicone for the sole purpose of augmentation mammaplasty. Adverse symptoms following these silicone injections were fever, hypoxemia, hemoptysis, and abnormal diffuse bilateral alveolar infiltrates in both lungs. Pulmonary hemorrhaging occurred, and this was substantiated by using the bronchoscope with the bronchoalveolar lavage (BAL). The alveolar macrophage obtained from the BAL contained large quantities of pleomorphic cytoplasmic particles, which in actual fact were silicone particles. They were identified as silicone by scanning electron microscopy and energy-dispersive analysis of x-rays. This evidently showed that silicone diffusion into the circulatory system and subsequent embolization of the lung. Pulmonary function studies had shown restrictive changes with increase or normal single-breath carbon monoxide diffusing capacity (Dsb). Perfusion lung scans were interpreted as showing diffuse abnormalities consisting of decreased peripheral uptake. Acute hypoxemic respiratory failure was noted in four of these patients. Silicone injections of this nature were therefore a respiratory risk and caused the inducement of pneumonitis.
在3年时间里，发现有7例患者仅为隆乳目的皮下注射硅酮后发生了急性肺炎。这些硅酮注射后的不良症状包括发热、低氧血症、咯血以及双肺弥漫性双侧肺泡浸润异常。发生了肺出血，通过支气管镜及支气管肺泡灌洗（BAL）得以证实。从BAL获得的肺泡巨噬细胞含有大量多形性胞质颗粒，实际上这些颗粒就是硅酮颗粒。通过扫描电子显微镜和X射线能谱分析将它们鉴定为硅酮。这显然表明硅酮扩散进入循环系统并随后栓塞肺部。肺功能研究显示有限制性改变，单次呼吸一氧化碳弥散量（Dsb）增加或正常。灌注肺扫描显示为外周摄取减少的弥漫性异常。其中4例患者出现急性低氧性呼吸衰竭。因此，这种性质的硅酮注射存在呼吸风险并可诱发肺炎。
