case_images: PMC9085291_01
case_images: Sagittal proton density (A,B) and axial silicone only sequence (C). The blue arrow shows the water-droplet signal inferring permeability change of the breast implant shell. The orange arrow demonstrates an intracapsular mass compatible with the silicone-induced granuloma of the breast implant fibrous capsule. There is also a capsular contraction in both implants.
case_images: fgwh-03-730276-g0001.jpg
case_images: PMC9085291_01_fgwh-03-730276-g0001.jpg
case_images: F1
case_images: The MRI also showed signals of gel bleed described as intracapsular masses with late contrast enhancement, silicone induced granuloma of breast implant capsule (SIGBIC), Figures 1, 2.
case_images: (A-D) Axial images of the same patient. T1 post-contrast (A,B), T1 subtraction (C), and silicone only sequence (D). The orange arrow shows an intracapsular mass with late contrast enhancement compatible with silicone-induced granuloma of breast implant capsule (SIGBIC). The blue arrow shows the water-droplet signal.
case_images: fgwh-03-730276-g0002.jpg
case_images: PMC9085291_01_fgwh-03-730276-g0002.jpg
case_images: F2
case_images: The MRI also showed signals of gel bleed described as intracapsular masses with late contrast enhancement, silicone induced granuloma of breast implant capsule (SIGBIC), Figures 1, 2.
case_images: (A-F) Show 4 mum paraffin slides stained with the MORO. An overview of capsule from patient with focal throughout the capsule, spots who are positive. A magnification of designated area's shown in B. Clearly to distinguish are the vacuoles filled with red coloured silicone fragments. During degradation these fragments become smaller. Bigger fragments are showed in (C,D) with a positive control visible in inset *. This gradual dispersion can be found throughout the capsule. Degradation of the silicone can be seen everywhere and eventually the silicone molecules will migrate into the body and can reach every spot. (E) Shows a silicone spot in the synovia of the arm. Small spots are scatterd true the interstitium entering the bloodvessels (arrow). These vacuoles and especially the small granules can also be found in small nervebundles, (F). Original microscopic magnification; (A,C) 100X, (B, D-F) 400x.
case_images: fgwh-03-730276-g0003.jpg
case_images: PMC9085291_01_fgwh-03-730276-g0003.jpg
case_images: F3
case_images: Figures 3A-F show a 4 mum paraffin slide stained with MORO. Larger fragments are shown in Figures 3C,D with a positive control visible, inset *. Figure 3E shows an area with smaller granular in the synovia of the arm, scattered through the interstitium and clearly visible in the wall of a blood vessel (arrow). These vacuoles, and especially the small granules, can also be found in small nerve bundles (Figure 3F).