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Imagen Clínica
Siliconoma pulmonar, una etiología a tener en cuenta
Lung Siliconoma, an Etiology to Consider
Fernando Cózar Bernal
Corresponding author
fcozarbernal@gmail.com

Autor para correspondencia.
, Julia González Fernández, Juan Carlos Girón Arjona
Servicio de Cirugía Torácica, Hospital Universitario Virgen Macarena, Sevilla, España
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          "es" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">&#40;A-B<span class="elsevierStyleBold">&#41;</span> Imagen de la TAC preoperatoria donde se aprecia la existencia de n&#243;dulos pulmonares bilaterales&#46; A&#41; n&#243;dulo pulmonar&#44; subpleural&#44; en segmento anterior del l&#243;bulo superior derecho&#46; B&#41; n&#243;dulos pulmonares en l&#243;bulo inferior izquierdo&#46; &#40;C-F&#41; Im&#225;genes histol&#243;gicas del n&#243;dulo pulmonar resecado durante la cirug&#237;a&#46; C&#41; Se observa a la izquierda par&#233;nquima pulmonar y alg&#250;n bronquiolo&#46; A derecha un n&#243;dulo constituido por c&#233;lulas de aspecto claro a este aumento con ribete linfoc&#237;tico incompleto &#40;variante de granuloma a cuerpo extra&#241;o&#41;&#46; D&#41; A mayor aumento se identifica que estas c&#233;lulas son de h&#225;bito histioc&#237;tico y tienen un amplio citoplasma &#171;blanco&#187; esto es&#44; vac&#237;o&#44; porque en el procesamiento la silicona se disuelve&#44; dejando el hueco&#46; E&#41; Granuloma a cuerpo extra&#241;o en el par&#233;nquima pulmonar cerca de una vena&#46; F&#41; A mayor aumento se ven los histiocitos y c&#233;lulas gigantes multinucleadas caracter&#237;sticos con mayor detalle&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Mujer de 52 a&#241;os sometida a mastectom&#237;a radical derecha con reconstrucci&#243;n inmediata por carcinoma lobulillar infiltrante estadio IA&#46; En seguimiento oncol&#243;gico le diagnostican un patr&#243;n radiol&#243;gico en suelta de globos &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#44; decidi&#233;ndose biopsia de uno de los n&#243;dulos para su tipificaci&#243;n histol&#243;gica&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Se realiza segmentectom&#237;a at&#237;pica del 3 derecho por videotoracoscopia siendo informado&#44; sorprendentemente&#44; como n&#243;dulo intrapulmonar constituido por material oleoso intracitoplasm&#225;tico y reborde linfocitario&#44; existiendo microgranulomas gigantocelulares con presencia de material oleoso intravascular&#44; concordante con el diagn&#243;stico de siliconoma pulmonar &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Se consens&#250;a actitud conservadora con respecto a los n&#243;dulos &#40;ya que su extirpaci&#243;n precisar&#237;a una lobectom&#237;a&#41;&#44; mediante seguimiento estrecho y recambio del implante de silicona&#44; el cual se presupone roto&#46; En sucesivos controles no hay modificaci&#243;n de las lesiones pulmonares&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">En 1964&#44; Winer describe por primera vez el &#171;siliconoma&#187; &#40;reacci&#243;n granulomatosa a cuerpo extra&#241;o producida por las siliconas l&#237;quidas en los tejidos y la fibrosis que las rodea&#41;&#46; El desarrollo de complicaciones tard&#237;as como los siliconomas locales o linfadenopat&#237;as est&#225; ampliamente publicado&#44; mientras que la diseminaci&#243;n perif&#233;rica al tejido subcut&#225;neo o la existencia de siliconomas intrapulmonares son extremadamente raras&#46; Solo hemos encontrado los publicados por Mu&#241;iz et al&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">1</span></a> y Dragu et al&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">2</span></a>&#44; que a diferencia del presente son lesiones &#250;nicas pulmonares&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflicto de intereses</span><p id="par0025" class="elsevierStylePara elsevierViewall">Ninguno de los autores presenta conflicto de intereses&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">La presente investigaci&#243;n no&#160;ha recibido ayudas espec&#237;ficas provenientes de agencias del sector p&#250;blico&#44; sector comercial o entidades sin &#225;nimo de lucro&#46;</p></span></span>"
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Article information
ISSN: 03002896
Original language: Spanish
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