PMC4900025_01
Axial noncontrast CT image showing an enlarged left internal mammary lymph node (arrow) measuring 1.6 x 2.1cm.
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On the staging CT, two enlarged left internal mammary lymph nodes were found, measuring 1.6 x 2.1cm (Fig. 1) and 1.1 x 1.2cm.
Sagittal (A) and axial (B) noncontrast CT images showing ruptured left silicone breast implant.
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The CT also showed the ruptured ipsilateral silicone implant (Fig. 2), which the patient was aware of from previous ultrasound imaging (not shown).
Axial noncontrast CT image shows the enlarged left internal mammary lymph node with biopsy needle inside and the intracapsular rupture of the left breast implant (arrow).
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As part of the staging, a 20G, CT-guided core biopsy (Speedybell, Biopsybell, Mirandola, Italy) of the enlarged internal mammary lymph node was performed, using a coaxial approach with a single 1cm throw (Fig. 3).
Histology H&E staining 400X magnification: Foreign-body granuloma with macrophages and numerous mutinucleate giant cella (white arrows) with large clear cytoplasmic vacuoles (green arrows), highly suggestive of siliconoma. Lymphocytes are black arrow.
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Histology showed a siliconoma (Fig. 4).