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 Dr Sampurna Roy MD

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Silicones are easily detected in tissue as small round to irregular droplets of amorphous refractile non-polarising material. Thick sections (10-30 micrometer thick) prevent loss of silicone droplets during tissue processing.

The silicones can be detected by adding stamp pad ink to the mounting medium. Non-Koehler, phase contrast & darkfield microscopy help to highlight the silicones.

Granuloma as a reaction to silicone is mainly found after extracellular rupture of an implant and after injections with silicones.

These granulomas may present as a tumour some distance from the implant.

Visit: FOREIGN BODY GRANULOMA OF SKIN

Microscopic patterns :

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In case of injection with liquid silicone - There are numerous cystic spaces and vacuoles partly filled with silicones surrounded by a thin layer of fibrous tissue  Foreign body giant cell reaction is minimal.
In case of extracapsular rupture - There are many giant cells of the foreign body type often containing silicones and foam cells together with lymphocytes.

Silicone granuloma.Dermatology. 2000;200(4):360-2.

Pathology of silicone leakage from breast implants.J Clin Pathol. 1998 Jul;51(7):493-7.

Histologic features of breast capsules reflect surface configuration and composition of silicone bag implants.Am J Clin Pathol. 1994 Nov;102(5):655-9.

Light microscopy techniques for the demonstration of silicone gel.Arch Pathol Lab Med. 1994 Oct;118(10):984-7.

Histologic changes and silicone concentrations in human breast tissue surrounding silicone breast prostheses.Plast Reconstr Surg. 1990 Jan;85(1):38-41.

Silicone granulomas: report of three cases and review of the literature.Hum Pathol. 1985 Jan;16(1):19-27.

Gross examination of the skin specimen

Reporting of biopsies taken for Inflam matory Skin Diseases

Lichenoid (Interface)Tissue Reaction Pattern

Psoriasiform Reaction Pattern

Vesiculobullous Reaction Pattern

Spongiform Reaction Pattern

Vasculopathic Reaction Pattern

Lichen planus-like lesions

Lichen Nitidus

Bullous Pemphigoid

Dermatitis Herpetiformis

Hailey-Hailey Disease 

Erythema Nodosum

Impetigo

Furuncle(Boil)

Carbuncle

Toxic Shock Syndrome

Rosacea

Granulomatous T-cell lymphoma