注射聚丙烯酰胺水凝胶隆乳后的乳腺病变

背景：聚丙烯酰胺水凝胶是一种人体软组织填充剂,主要用于注射隆乳,大量文献报道它会引起乳房硬结、感染、凝胶移位、乳房变形、乳腺增生甚至乳腺癌等并发症。目的：观察聚丙烯酰胺水凝胶注射隆乳后乳腺的病理学改变。方法：收集聚丙烯酰胺水凝胶注射隆乳后病例35例,采用苏木精-伊红染色、免疫组织化学染色、PAS和AB染色进行病理学观察。结果与结论：35例注射隆乳后的病例,26例发生了异物肉芽肿,发生率为74%(26/35);3例发生了乳腺癌,发生率为9%(3/35)。病灶内见大小不等的囊腔,部分囊腔完全由组织细胞、异物巨细胞和纤维组织填充。病变处和周围乳腺组织、脂肪及横纹肌组织均可见变性坏死,部分呈凝固性坏死。部分病例病变周围乳腺导管部分呈增生性改变,表现为普通型增生、不典型增生、原位癌或浸润癌,提示聚丙烯酰胺水凝胶对人体组织有毒性作用,会导致组织的变性坏死和引起异物肉芽肿反应,其和乳腺癌的发生有一定的相关性。

Breast lesions following breast augmentation with polyacrylamide hydrogel injection

BACKGROUND:Polyacrylamide hydrogel is a kind of soft tissue fillers, mainly used for augmentation via injection.OBJECTIVE:To study the tissue pathology of breast lesions associated with polyacrylamide hydrogel injection for augmentation mammoplasty.METHODS:Thirty-five cases of breast lesions after polyacrylamide hydrogel injection were studied by using hematoxylin-eosin staining, immunohistochemical staining, PAS and AB staining. RESULTS AND CONCLUSION:Twenty-six cases showed foreign-body granuloma and 3 cases showed breast cancer in 35 cases of polyacrylamide hydrogel injection for augmentation mammoplasty. Incidence of foreign-body granuloma was 74.3%, and incidence of breast cancer was 8.6% after polyacrylamide hydrogel injection for augmentation mammoplasty. The process was composed of mutliple cysts, in which there were a lot of irregular blue foreign material, surrounded by foreign body giant cells and histiocyte. Some patients showed acute inflammation with abscess formation. There was coagulation necrosis in breast tissue, fat and muscle. There were intraductual proliferative lesions in the surrounding breast tissue. Polyacrylamide hydrogel has certain toxicity to human body and induces coagulation necrosis and foreign-body granuloma in tissue. It may be related to the development of breast cancer.