PMC4899675_01
71-year-old female with pleural silicone granuloma. Routine surveillance CT chest in soft-tissue (A) and lung (B) windows obtained several years before the current presentation demonstrated an intact silicone breast implant with no evidence of pleural or parenchymal abnormality (B). (White arrow denotes the old ipsilateral thoracotomy site.)
gr1.jpg
PMC4899675_01_gr1.jpg
fig1
Since the removal of carcinoid tumor, no evidence of disease recurrence had been found on the preceding surveillance CT studies (Fig.1).
71-year-old female with pleural silicone granuloma. Coronal and axial CT of the chest show a pulmonary nodule along the right major fissure with similar density to silicone implant (A and B) and mild FDG uptake (C).
gr2.jpg
PMC4899675_01_gr2.jpg
fig2
Computed tomography (CT) of the chest demonstrated diffuse pleural thickening along the right major fissure with several areas of focal pleural thickening, including a 17-mm nodule along the right major fissure (Fig. 2).
71-year-old female with pleural silicone granuloma. Axial CT (A) shows an asymmetrically smaller right breast implant with folding of the collapsed shell (linguine sign) as well as an extracapsular soft-tissue density posteriorly, adjacent to the old thoracotomy scar. The appearance suggests rupture of the breast implant with extracapsular extension of its content. The soft-tissue density demonstrates mild FDG uptake (B) consistent with a silicone granuloma secondary to ruptured implant.
gr3.jpg
PMC4899675_01_gr3.jpg
fig3
A chest-wall soft-tissue mass just posterior to the right breast implant was concerning for recurrence of carcinoma (Fig. 3).
71-year-old female with pleural silicone granuloma. Biopsy of right pleural-based nodule demonstrated granulomatous inflammation with numerous vacuoles containing refractile material (arrows), consistent with silicone.
gr4.jpg
PMC4899675_01_gr4.jpg
fig4
Biopsy of the nodule along the major fissure, performed based on the clinical suspicion of pleural metastases, revealed silicone surrounded by foreign-body granulomatous reaction and no malignant cells (Fig. 4).