Acute Pulmonary Embolism by Silicone Injection: Radiologic Findings

실리콘액 주사에 의한 급성 폐색전증: 영상의학적 소견

Silicone is widely used for medical purposes in breast augmentation and other cosmetic procedures. Illegal injections of silicone in human beings might have adverse effects and one of the serious problems is a silicone embolism. We experienced five cases of unusual respiratory difficulties after an injection of liquid silicone in the breast, vagina, uterus, and hip. They were all young adult females, who were previously healthy. One of them died after the injection. The three remaining patients were admitted because of dyspnea, coughing, chest discomfort and bilateral pulmonary infiltration after the silicone injection. A transbronchial lung biopsy and autopsy disclosed many oil like materials filling the alveolar septal capillaries. Three patients underwent a computed tomogram (CT), which revealed multifocal airspace consolidations at the peripheral and nondependent portions of both lungs, which is a different finding from other thromboembolisms. Lung scans of the disclosed abnormalities were compatible with silicone induced pulmonary embolism.

실리콘의 부적절한 피하 주입으로 발생한 폐색전증의 방사선학적 특징은 초기에는 호흡기 증상만 보이지만 염증 매개성 반응이 진행함에 따라 양측 폐 침윤이 급격히 진행하는 것을 볼 수 있었다. 또한 실리콘의 비중이 혈액보다 낮아 중력 비의존성 분포를 보임을 알 수 있었고, 이는 기존의 다른 원인에 의한 폐색전증과 구분되는 소견이다.