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Chromium-induced lymph node histiocytic proliferation after hip replacement. A case report
Mariana Munichor1, Hector Cohen, Gershon Volpin
1Department of Pathology, Rambam Medical Center, Department of Pathology, B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Acta Cytologica
|April 11, 2003
Summary
Fine needle aspiration diagnosed chromium-related lymph node metallosis in a patient with a hip prosthesis. This technique effectively identifies foreign metallic particles in lymph nodes near joint replacements.
Area of Science:
- Orthopedic surgery
- Pathology
- Materials science
Background:
- Prosthetic joint replacements utilize materials like titanium, cobalt, and chromium.
- Degenerative joint disease and arthritis are common indications for joint arthroplasty.
- Metal-on-metal hip prostheses can lead to wear debris.
Observation:
- A 78-year-old woman developed a pelvic mass 8 years after total hip arthroplasty.
- Fine needle aspiration revealed macrophages with metallic particles.
- Pelvic lymph nodes showed sinus histiocytosis with foreign material.
Findings:
- Ultrastructural analysis confirmed foreign particles.
- Energy dispersive x-ray microanalysis identified chromium.
- This is the first report of chromium-related lymph node metallosis diagnosed via fine needle aspiration.
Implications:
- Fine needle aspiration is a valuable tool for diagnosing metallosis in lymph nodes draining prosthetic sites.
- Polarized microscopy aids in identifying foreign materials.
- Distinguishing metallosis from metastatic carcinoma is crucial for patient management.