Axillary lymphadenopathy due to Swanson implants

Area of Science:

• Rheumatology
• Pathology
• Biomaterials Science

Background:

• Rheumatoid arthritis (RA) management often involves surgical interventions, including the use of silicone-based implants.
• Swanson silastic elastomer implants are utilized for hand reconstruction in patients with severe RA.
• Long-term implant presence can potentially lead to unforeseen complications.

Observation:

• An elderly female patient with a history of RA presented with unilateral axillary lymphadenopathy.
• The patient had undergone placement of Swanson silastic elastomer implants in her right hand 7 years prior.
• No apparent cause for the lymphadenopathy was initially identified, raising concerns for malignancy.

Findings:

• Histopathological examination of the axillary lymph node revealed the presence of foreign body giant cells.
• These cells showed a reaction to silastic material, consistent with a foreign body response.
• Crucially, no evidence of malignancy was detected in the lymph node.

Implications:

• This case highlights a rare complication of silastic elastomer implants, presenting as lymphadenopathy mimicking malignancy.
• It underscores the importance of considering implant-related foreign body reactions in the differential diagnosis of lymphadenopathy, even years after implantation.
• Further awareness and investigation may be warranted given the widespread use of such implants in RA patients.