聚丙烯酰胺水凝胶注射隆乳术后并发症的病理组织学观察

目的 研究聚丙烯酰胺水凝胶注射隆乳术后乳腺的病理组织学改变,探讨导致并发症的可能原因.方法 收集87例因注射聚丙烯酰胺水凝胶隆乳术后出现并发症的手术取出物,固定后常规脱水、石蜡包埋,切片、H＆E染色,显微镜下观察取出组织的病理组织学改变.结果 聚丙烯酰胺水凝胶注射隆乳术后常见的临床症状为乳房硬结包块、注射物游走、疼痛以及感染.手术取出物最主要的病理组织学改变为聚丙烯酰胺水凝胶在乳房内脂肪、腺体及肌肉组织内渗透、游走.注射凝胶周围组织最集中的改变是异物反应（34/87,39.08%）,未见明确纤维化或纤维性包膜.部分病例（12/87,13.8%）可见腺体组织破坏及炎症改变,未见致癌性改变.结论 聚丙烯酰胺水凝胶是一种游走性物质,在乳腺组织内弥漫渗透,不能完全被吸收.聚丙烯酰胺水凝胶能诱导异物反应,形成不同阶段的病理组织学构像,对周围腺体组织及肌肉组织有一定损害作用.

Histopathological observation on the complications associated with augmentation mammoplasty by injection of polyacrylamide hydrogel

Objective To explore the histopathological changes in the breast after injection of polyacrylamide hydrogel (PAHG) and the possible causes of complications associated with PAHG augmentation mammoplasty. Methods The breast samples from 87 women, who had undergone PAHC augmentation mammoplasty in other hospitals or clinics and occurred complications, received repair surgery in our hospital. We examined the pathological changes in these breast tissues. Results The women injected with PAHG into the breast occurred complications clinically, including nodularity and lumps, gel migration, pain, and infection. The main histopathological changes in the mammary tissues taken from the majority of individuals with com-plication were integration and migration of PAHG within the fat, muscle and glandular tissues of the breast. The most marked findings (34/87, 39.08%) were foreign body reactions without prominent fibrosis or fibrous capsule. Destruction of glandular tissue and inflammatory changes could also be found in some patients (12/87, 13.8%). Carcinogenetic changes of the mammary gland were not found. Conclusions PAHG is a migratory material, which penetrates diffusely within the breast and not be fully absorbed. PAHG can induce foreign body reaction, which forms different histopathologic stages and can induce cell injury in the breast gland and the nearby muscular tissues.