Yonsei Med J.  2002 Apr;43(2):152-159. 10.3349/ymj.2002.43.2.152.

Clinicopathologic Review of Pulmonary Silicone Embolism with Special Emphasis on the Resultant Histologic Diversity in the Lung: A Review of Five Cases

• Chung KY
• Kim SH
• Kwon IH
• Choi YS
• Noh TW
• Kwon TJ
• Shin DH

• KMID: 1118963
• DOI: http://doi.org/10.3349/ymj.2002.43.2.152

Abstract

It is known that the subcutaneous injection of silicone can lead to severe pulmonary complications, followed in some patients by respiratory failure. Currently, silicone is being increasingly applied in the field of plastic surgery and, unfortunately, the illicit injection of silicone fluid by uncertified practitioners is not uncommon in Korea. We offer a critical pathologic review of 5 cases of pulmonary silicone embolism following illegal injection to the vaginal wall, four of which were fatal and came to legal autopsy. Our findings again confirm that subcutaneously injected silicone can gain access to the pulmonary vascular tree and cause pulmonary embolism. The histologic changes observed in the lung are variable and include four patterns i.e., the mere presence of silicone emboli, congestion and hemorrhage, acute pneumonitis, and diffuse alveolar damage despite the severe critical course in all cases. We were unable to find any histologic pattern that correlates well with the clinical course. Apart from producing emboli in the pulmonary vessels, subcutaneous injection of silicone can obviously cause serious pulmonary disease due to its ability to induce acute to induce acute pneumonitis and even possibly acute respiratory distress syndrome.

Keyword

Silicone; pulmonary embolism; retrospective study; pathology

MeSH Terms

Adult
Case Report
Fatal Outcome
Female
Human
Injections
Middle Age
Pulmonary Embolism/*chemically induced/*pathology
Silicones/administration & dosage/*adverse effects
Vagina