title: Pathological and biophysical findings associated with silicone breast implants: a study of capsular tissues from 86 cases.
abstract: Breast implant capsular tissues from 86 cases were studied to characterize the relationship between capsular findings and the type of implant used. Tissues were examined by light microscopy, immunohistochemistry, scanning electron microscopy/energy dispersive x-ray analysis and Fourier transform infrared, and Raman microspectroscopy. Capsular pathology was influenced by the structure and composition of the implant. A pseudoepithelium at the inner capsular surface (synovial metaplasia) was noted with silicone gel-filled, saline-filled, and polyurethane-coated implants, and disproportionatelywith textured surface implants. Immunohistochemical studies of pseudoepithelium supported a macrophage/histiocyte cellular origin. Talc was identified intracellularly within macrophages in 42 cases. Capsular calcification was strongly associated with the presence of implant stabilization patch material. Infrared spectra were used to identify silicone, talc, Dacron, and two different types of polyurethane in capsular tissues. Micropapillary structures identified at the pseudoepithelial surface have, to the authors' knowledge, not been previously described.
authors.affiliation: Department of Environmental and Toxicologic Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000, USA.
authors.forename: J L
authors.initials: JL
authors.lastname: Luke
authors.forename: V F
authors.initials: VF
authors.lastname: Kalasinsky
authors.forename: R P
authors.initials: RP
authors.lastname: Turnicky
authors.forename: J A
authors.initials: JA
authors.lastname: Centeno
authors.forename: F B
authors.initials: FB
authors.lastname: Johnson
authors.forename: F G
authors.initials: FG
authors.lastname: Mullick
mesh_terms: D001940:Breast / Q000473:pathology*; D018427:Breast Implants; D002114:Calcinosis / Q000473:pathology; D003238:Connective Tissue / Q000473:pathology; D003240:Connective Tissue Diseases / Q000473:pathology; D004577:Electron Probe Microanalysis; D004848:Epithelium / Q000473:pathology; D005079:Excipients / Q000032:analysis; D005260:Female; D005782:Gels; D006644:Histiocytes / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008264:Macrophages / Q000473:pathology; D008679:Metaplasia; D008855:Microscopy, Electron, Scanning; D015591:Microspectrophotometry; D011093:Polyethylene Terephthalates / Q000032:analysis / Q000737:chemistry; D011140:Polyurethanes / Q000032:analysis / Q000737:chemistry; D011474:Prosthesis Design; D012828:Silicones / Q000032:analysis / Q000737:chemistry; D012965:Sodium Chloride / Q000032:analysis / Q000737:chemistry; D017550:Spectroscopy, Fourier Transform Infrared; D013059:Spectrum Analysis, Raman; D013499:Surface Properties; D013627:Talc / Q000032:analysis
chemical_list: D005079:Excipients; D005782:Gels; D011093:Polyethylene Terephthalates; D011140:Polyurethanes; D012828:Silicones; D013627:Talc; D012965:Sodium Chloride