Clinicopathologic review of pulmonary silicone embolism with special emphasis on the resultant histologic diversity in the lung--a review of five cases.
It is known that the subcutaneous injection of silicone can lead to severe pulmonary complications, followed in some patients by respiratory failure. Currently, silicone is being increasingly applied in the field of plastic surgery and, unfortunately, the illicit injection of silicone fluid by uncertified practitioners is not uncommon in Korea. We offer a critical pathologic review of 5 cases of pulmonary silicone embolism following illegal injection to the vaginal wall, four of which were fatal and came to legal autopsy. Our findings again confirm that subcutaneously injected silicone can gain access to the pulmonary vascular tree and cause pulmonary embolism. The histologic changes observed in the lung are variable and include four patterns i.e., the mere presence of silicone emboli, congestion and hemorrhage, acute pneumonitis, and diffuse alveolar damage despite the severe critical course in all cases. We were unable to find any histologic pattern that correlates well with the clinical course. Apart from producing emboli in the pulmonary vessels, subcutaneous injection of silicone can obviously cause serious pulmonary disease due to its ability to induce acute to induce acute pneumonitis and even possibly acute respiratory distress syndrome.
Chung
Kyung Young
KY
Department of Pathology, Yonsei University College of Medicine, C.P.O. Box 8044, Seoul 120-752, Korea.
Kim
Se Hoon
SH
Kwon
Il Hoon
IH
Choi
Young Sik
YS
Noh
Tae Woong
TW
Kwon
Tae Jung
TJ
Shin
Dong Hwan
DH
D000328:Adult; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007267:Injections; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000139:chemically induced* / Q000473:pathology*; D012828:Silicones / Q000008:administration & dosage / Q000009:adverse effects*; D014621:Vagina
D012828:Silicones