Histological and immunohistochemical characteristics of capsular synovial metaplasias that form around silicone breast implants

Boháč, Martin; Danišovič, Ľuboš; Danihel, Ľ; Fedeleś, J; Beerová, Nikoleta; Polák, Štefan; Varga, Ivan

doi:10.2478/s11756-018-0024-7

Cited by 5 publications

(1 citation statement)

References 18 publications

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“…Immunohistochemical staining was performed on 3- to 5-µm tissue sections as described previously. 18 The following antibodies were used: mouse monoclonal antibody for the alpha subunit of smooth muscle actin (α-SMA, 1A4 clone; Dako, Glostrup, Denmark) as a marker of activated myofibroblasts 19 ; rabbit polyclonal antibody for collagen type I (COL I, ab34710; Abcam, Cambridge, MA) and rabbit polyclonal antibody for collagen type III (COL III, ab7778; Abcam); mouse monoclonal antibody for CD68 (KP1 clone, ab955; Abcam) as a marker of macrophages 20 ; mouse monoclonal antibody for CD34 (Clone QBEnd/10; Biocare Medical) as a marker of microvessel density 21 ; and mouse monoclonal antibody for CD3 (Anti-Human ready to use IR503; Dako) as a marker of T-lymphocyte population. 22 Microscopic images were captured by a Videocam (SPOT Insight; Diagnostic Instruments, Inc., Sterling Heights, MI) connected to an Olympus BX-51 light microscope (Olympus, Tokyo, Japan) and processed with an Image Analysis System (Delta Sistemi, Rome, Italy).…”

Section: Methodsmentioning

confidence: 99%

Histologic and Immunohistochemical Evaluation of Human Breast Capsules Formed around Five Different Expander Surfaces

Cagli

Carotti

Segreto

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Polyurethane (PU) coating and implant texturization were designed to reduce the incidence of capsular contracture (CC), even if the link between surface type and CC remains unclear. To date, the etiopathogenetic aspects have not been fully clarified. The aim of this study was to evaluate capsules formed around five different breast expanders. Methods: Thirty patients were divided into randomized groups implanted with five different expanders: smooth, coated with PU foam (poly), with a low-microtextured, high-microtextured, and macrotextured surface (L-micro, H-micro, macro). Specimens of the capsules were removed at implant reconstruction and evaluated for morphology and immunohistochemistry expression of α-smooth muscle actin (α-SMA), collagen type I and III, CD68, CD34, and CD3. Remodeling Combined Index was also evaluated. Results: Expression of α-SMA was significantly increased in smooth capsules versus poly, low-microtextured, and high-microtextured groups (P = 0.007; P = 0.010; P = 0.028), whereas the prevalence of collagen type I in smooth capsules and collagen type III in poly capsules identified a stable versus an unstable tissue. Remodeling Combined Index and α-SMA showed an inverted correlation. CD68 and CD34 cellular expression increased significantly in poly capsules with respect to smooth (P < 0.001; P < 0.001) and macrotextured groups (P < 0.001; P < 0.001). CD3 showed no significant difference among the groups. Conclusion:In this human study, the authors observed that increased tissue remodeling and reduced myofibroblast activation, along with the inflammatory infiltration and neoangiogenesis, especially in the poly and low-microtextured groups, might promote the formation of an unstable and less fibrotic capsule, lowering the risk of CC.

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Section: Methodsmentioning

confidence: 99%

Histologic and Immunohistochemical Evaluation of Human Breast Capsules Formed around Five Different Expander Surfaces

Cagli

Carotti

Segreto

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Comparison of inflammatory response and synovial metaplasia in immediate breast reconstruction with a synthetic and a biological mesh: a randomized controlled clinical trial

Hansson

Burian

Hallberg

2019

Journal of Plastic Surgery and Hand Surgery

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The aim of this study was to compare inflammatory response and synovial metaplasia in implant-based immediate breast reconstruction with a biological mesh (Veritas V R) with that of a synthetic mesh (TIGR V R Matrix Surgical Mesh). We hypothesize that the inflammatory response and formation of synovial metaplasia might be different and the rate of capsular contracture therefore different. The patients were recruited from the Gothenburg TIGR V R /Veritas V R Study (ClinicalTrials.Gov identifier NCT02985073). All referrals for bilateral immediate breast reconstruction were assessed for inclusions. During the operation, the patients were randomized to which sides the biological and the synthetic mesh were going to be applied. During the implant exchange biopsies were taken. Biopsies were taken from 30 breasts in 15 patients. There seem to be more myofibroblast and neovascularization in the biological meshes than in the synthetic and the collagen fibers seem to be aligned in an irregular pattern with both parallel and vertical fibers. In the synthetic meshes, there were more giant cells and foreign body reaction and the collagen fibers were loosely and well aligned, oriented parallel to the surface of the implant. Synovial metaplasia was seen in the majority of both the biological and the synthetic meshes. The histological patterns in early capsules from biological and synthetic meshes vary considerably. Nonetheless, it is unknown what role different cell types have in capsular formation in the long run and there was no difference in clinical capsular contracture at the clinical follow-up in this study.

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Cutaneous metaplastic synovial cyst in Ehlers‐Danlos syndrome

Fernández-Flores

Barja

2020

J Cutan Pathol

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Classic Ehlers‐Danlos syndrome (EDS) is a connective tissue disorder characterized by laxity. The skin, as one of the organs involved, shows hyperextensibility, which makes it prone to trauma. In this context, it would seem logical for cutaneous synovial metaplasia, which is considered a form of repair, to be commonly found in cases of EDS. However, there are only two previously published cases of synovial metaplasia in EDS. We present a third case in a 56‐year‐old woman with painful redundant skin in both elbows and knees for whom a skin fold of the left elbow was removed to relieve her symptoms. The biopsy showed preservation of the elastic and collagen fibers. The main alteration was the evidence of dermal cystic spaces lined by fibrinoid rests with focal pseudopapillary projections. However, in some zones the cellular lining was preserved, and it was composed of vimentin‐positive, fibroblast‐like flat, elongated cells, as well as CD68‐positive macrophages. No birefringent particles were found in an examination under polarized light.

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Histological and immunohistochemical characteristics of capsular synovial metaplasias that form around silicone breast implants

Cited by 5 publications

References 18 publications

Histologic and Immunohistochemical Evaluation of Human Breast Capsules Formed around Five Different Expander Surfaces

Histologic and Immunohistochemical Evaluation of Human Breast Capsules Formed around Five Different Expander Surfaces

Comparison of inflammatory response and synovial metaplasia in immediate breast reconstruction with a synthetic and a biological mesh: a randomized controlled clinical trial

Cutaneous metaplastic synovial cyst in Ehlers‐Danlos syndrome

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