Acute Pneumonitis Presumed to be Silicone Embolism

Tokuji MATSUBA; Tatsunari SUJIURA; Mikio IREI; Yukio KYAN; Nobuyoshi KUNISHIMA; Hisataka UCHIMA; Seishiro MIYAGI; Yasushi IWATA; Kenichi MATSUBA

doi:10.2169/internalmedicine.33.481

Tokuji MATSUBA, Tatsunari SUJIURA, Mikio IREI, Yukio KYAN, Nobuyoshi KUNISHIMA, Hisataka UCHIMA, Seishiro MIYAGI, Yasushi IWATA, Kenichi MATSUBA

Author information

Tokuji MATSUBA
The Departments of Medicine and Pathology, Okinawa Chubu Hospital
Tatsunari SUJIURA
The Departments of Medicine and Pathology, Okinawa Chubu Hospital
Mikio IREI
The Departments of Medicine and Pathology, Okinawa Chubu Hospital
Yukio KYAN
The Departments of Medicine and Pathology, Okinawa Chubu Hospital
Nobuyoshi KUNISHIMA
The Departments of Medicine and Pathology, Okinawa Chubu Hospital
Hisataka UCHIMA
The Departments of Medicine and Pathology, Okinawa Chubu Hospital
Seishiro MIYAGI
The Departments of Medicine and Pathology, Okinawa Chubu Hospital
Yasushi IWATA
The Department of Pathology, Kyushu Kohsei-Nenkin Hospital
Kenichi MATSUBA
The Department of Medicine, Kitakyushu Moji Hospital

Keywords: silicone injection, acute silicone pneumonitis, mammary augmentation, TBLB (transbronchial lung biopsy), BAL (bronchoalveolar lavage)

JOURNAL FREE ACCESS

1994 Volume 33 Issue 8 Pages 481-483

DOI https://doi.org/10.2169/internalmedicine.33.481

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Abstract

A 39-year-old housewife who underwent intramammary injections of a proprietary silicone fluid mixture showed clinical and novel transbronchial lung biopsy (TBLB) findings. She presented with complaints of progressive dyspnea, dry cough, and pleuritic chest pain 2 days after the last silicone injections. The chest X-ray and CT scan showed diffuse interstitial infiltrates. TBLB demonstrated translucent, presumably silicone globules embolized within the pulmonary capillaries. The documentation of intramammary injections, the clinical and radiographic features of acute pneumonitis, and the histopathologic evidence by TBLB, may support the causal relationship between illicit injections and the silicone embolism. We discuss the pathogenesis and urge that this potentially toxic source of pulmonary embolism be removed.
(Internal Medicine 33: 481-483, 1994)

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