乳腺硅胶假体包膜的临床病理分析

目的 分析乳腺硅胶假体包膜的临床病理特点。方法 通过光镜和免疫组化对来自17位患者的31份乳腺硅胶假体包膜进行病理组织学观察。结果 31份乳腺硅胶假体包膜镜下均由纤维组织构成，17份显慢性炎症，26份胶原纤维增生伴有玻璃样变性，13份可见硅胶肉芽肿形成，5份伴钙化，18份内面可见滑膜样化生的上皮。免疫组化表现为vimenfin和CD68（＋），CK（-）。1份包膜周围乳腺组织伴有平坦上皮不典型增生（DINlA）。结论 乳腺硅胶假体包膜是机体对乳腺假体的局部免疫反应和慢性炎症过程的结果，滑膜样化生的上皮来源于组织细胞。硅胶肉芽肿、钙化和滑膜样化生均与植入时间有关。文献中有鳞状上皮化生伴鳞癌的报道，因此，病理工作者在外检中应提高认识并充分取材避免漏诊。

Breast silicone implant capsule: a clinicopathologic study

Objective To study the clinicopathological characteristics of breast implant capsule.Methods 31 pieces of breast silicone implant capsules from 17 patients were studied by histopathological observation and immunohistochemical staining.Results 31 pieces of breast implant capsule were all composed of fibrous tissue,17 pieces were characterized by infiltration of chronic inflammatory cells,26 pieces showed proliferation of collagen accompanied by hyaline degeneration,13 pieces with formation of silicone granulomas,5 pieces with calcification,and 18 pieces with synovial metaplasia epithelium in the inner surface.The synovial metaplasia epithelium was positive for vimentin and CD68,and negative for CK.1 piece exhibited flat epithelial atypia(DIN1A) in the sorrounding breast tissue.Conclusion The formation of breast implant capsule is the results of the local immune reaction and chronic inflammatory process.The synovial metaplasia epithelium derives from histiocytes.Silicone granuloma,calcification and synovial metaplasia correlate with implant duration.A case,in which a woman has a squamous cell carcinoma in the capsule,was reported in the literature.Therefore,pathologists should pay more attention to full gross checkup to avoid any misdiagnosis.