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Published on: July 3, 2018
Light microscopy techniques for the demonstration of silicone gel
D S Raso1, W B Greene, J J Vesely
1Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston 29425-6760.
Insights
Identifying silicone gel in tissue samples is challenging. This study found that thicker sections, specific microscopy techniques, and specialized staining significantly improve silicone detection in histologic and cytologic specimens.
Area of Science:
- Histopathology
- Materials Science
Background:
- Conventional light microscopy struggles to identify silicone gel in histologic and cytologic specimens.
- Accurate identification of silicone is crucial for diagnosing complications associated with silicone implants.
Purpose of the Study:
- To investigate alternative light microscopy techniques for silicone gel identification.
- To optimize specimen staining and preparation methods for enhanced silicone detection.
Main Methods:
- Examined periprosthetic capsules, granuloma, and synovial biopsy specimens from women with silicone breast implants.
- Utilized varying section thicknesses (4-30 microns) and common stains.
- Correlated findings with electron probe microanalysis.
- Tested unstained and stained silicone gel smears with Papanicolaou and Diff Quik stains.
- Evaluated non-Koehler, phase contrast, and darkfield microscopy.
- Applied a nonparticulate commercial ink to mounting media for enhanced negative staining.
Main Results:
- Silicone gel was observed to be refractile, nonpolarizable, and nonstainable with conventional methods.
- Thicker tissue sections prevented silicone "dropout" and improved contrast via negative staining.
- Phase contrast and darkfield microscopy significantly enhanced silicone identification ease.
- Staining mounting media with commercial ink improved negative staining detection of silicone gel.
Conclusions:
- Thicker sections, advanced microscopy (phase contrast, darkfield), and specific staining techniques (negative staining with ink) greatly improve silicone gel identification in histologic and cytologic specimens.
- These methods offer a more reliable approach compared to conventional light microscopy for evaluating silicone-related pathologies.
Abstract:
Because of the difficulty in identifying silicone gel in histologic and cytologic specimens by means of conventional light microscopy, we investigated alternative light microscopy techniques, as well as specimen staining and preparation. Specimens from six periprosthetic capsules, one silicone granuloma specimen, and one synovial biopsy specimen obtained from women with silicone breast implants were cut at 4-, 10-, 20-, and 30-microns sections, stained with a variety of common stains, and correlated with electron probe microanalysis. In addition, a commercial silicone gel and silicone gel extracted from a previously implanted silicone breast prosthesis were smeared and examined unstained or stained with Papanicolaou and Diff Quik. Silicone was noted to be refractile, nonpolarizable, and nonstainable. Thicker sections prevented silicone "dropout" during processing and increased the contrast between stained tissue and unstained silicone (negative staining). The relative ease of silicone identification was greatly increased with non-Koehler, phase contrast, and darkfield microscopy. Staining the mounting media of hematoxylin-eosin-stained sections with a nonparticulate commercial ink allowed enhanced negative staining detection of silicone gel.
