Silicone lymphadenopathy: a report of two cases, one with concomitant malignant lymphoma

Two cases of axillary lymphadenopathy induced by foreign body reaction to silicone particles are presented. Both were patients with longstanding arthritis who had silastic metacarpophalangeal joint implants; one patient also had concomitant lymphoma. The material was conclusively identified as silicone by electron microprobe analysis. With currently increasing numbers of silastic finger joint arthroplasties performed for rheumatoid arthritis, silicone lymphadenopathy should be considered in the differential diagnosis of axillary node enlargement in these patients. A history of previous silastic arthroplasty may not always be made available to the pathologist but the histological appearances are sufficiently characteristic, in our opinion, to warrant this history being sought.