Cytological Features of Breast Peri-Implant Synovial Metaplasia

Stone, Jason; Boost, Terese

doi:10.1159/000369054

Cited by 10 publications

(16 citation statements)

References 2 publications

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“…Papillary synovial spherules consisted of an extracellular matrix in which cells were embedded. Larger spherules resembled those previously described with nuclear crowding and an outer lining of acellular stroma . Another interesting feature of the present case, and not previously mentioned, was the presence of a thick, dense mucoid background with dispersed macrophages.…”

Section: Discussionsupporting

confidence: 87%

“…Our case resembles the cytologic features previously reported but shows some important differences. Rather than the large fragments illustrated by Stone and Boost, our smears were dominated by numerous, small to medium size three‐dimensional spherules. At a low magnification they created a worrisome image.…”

Section: Discussionsupporting

confidence: 85%

“…The present case and the previously reported one by Stone and Boost have a common remarkable papillary configuration of the synovial metaplastic process. The morphology of synovial metaplasia can vary according to the type of prosthetic implant used.…”

Section: Discussionsupporting

confidence: 77%

“…On the contrary, textured implants tend to show a knob‐like, papillary inner surface . In the report by Stone and Boost the type of implant is not mentioned but ours corresponded to a textured implant. We have studied six other cytologic cases of peri‐implant fluid specimens in which a simultaneous histologic study of the fibrous capsule was available.…”

Section: Discussionmentioning

confidence: 55%

“…After detailed examination and histologic correlation we believe it corresponds to papillary synovial metaplasia. A review of the medical literature revealed one previous cytologic description . Since breast implants are being used with increasing frequency, pathologists should be aware of the cytologic features of this peculiar lesion.…”

Section: Introductionmentioning

confidence: 99%

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Cytological features of breast peri‐implant papillary synovial metaplasia

Jiménez‐Heffernan

Bárcena

Muñoz‐Hernández

2018

Diagnostic Cytopathology

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Synovial metaplasia is a peculiar form of metaplasia seen in the inner lining of the fibrous capsule that surrounds breast implants. Since the description of breast-implant associated anaplastic large cell lymphoma it is increasingly common to receive periprosthetic breast fluid collections for pathologic analysis. We describe a case of breast-implant papillary synovial metaplasia that showed remarkable cytologic findings. A review of the medical literature revealed one previous cytologic description. The patient, A 53-year-old woman underwent surgery because of capsular contracture of textured, silicone breast implants. During surgery, 5 ml of peri-implant fluid collection fluid and the fibrotic capsules were submitted for pathologic analysis. The fluid was dense and smears showed abundant mucoid material that distributed on the background as a thick layer showing a wrinkled, "plastic food wrap" pattern. Numerous ball-like, three-dimensional spherical structures with a very well-defined contour were present. At low power magnification they created a worrisome cytologic image. Spherules consisted of cells embedded in a fibrous extracellular matrix. Cells showed round to oval nuclei with no pleomorphism. In the outer part of the spherules oval to spindle nuclei, parallel to the surface were evident. Histology of the resected capsules revealed remarkable papillary synovial metaplasia in addition to fibrosis and silicone deposition. In our opinion the spherules observed on cytology correspond to detached papillary fragments of synovial metaplasia. Their cytologic features are characteristic enough to permit a specific recognition avoiding misinterpretations. Pathologists must consider this diagnostic possibility whenever evaluating breast peri-implant fluid accumulations.

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Section: Discussionsupporting

confidence: 87%

Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 55%

Section: Introductionmentioning

confidence: 99%

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