Silicone lymphadenopathy

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Clinical History:
A 69 year old female patient with subcutaneous mastectomy and inlay-reconstruction due to invasive lobular carcinoma on the right side ten years ago, presenting now for follow up MR-mammography. The patient was free of complaints. An external rupture of the silicon-inlay was known.

Diagnosis:
Silicone lymphadenopathy

MR Technique:
1.5-T system (Magnetom Avanto, Siemens Healthcare, Erlangen, Germany) using a standard bilateral breast coil. (A) Unenhanced T1-weighted 3D gradient-echo sequence (1.6 mm axial slice, field of view 320 mm, matrix 512×512, TR/TE 4/1.5 ms) (B) T1-weighted 3D gradient-echo sequence (1.6 mm axial slices, field of view 320 mm, matrix 512×512, TR/TE 4/1.5 ms acquired every 50 s) after bolus injection of 0.2 mmol of Gd-DOTA per kilogram of body weight, 6th of 8 series, subtracted image.  (C) T2-weighted turbo spin-echo sequence (3 mm axial slices, field of view 320 mm, matrix 512×512, TR/TE 4400/104 ms). (D) Silicone sensitive short tau inversion recovery sequence (4 mm axial slice, field of view 320 mm, matrix 512×512, TR/TE 9000/67 ms).

Imaging Findings:
Parasternal on the right side an oval lesion with sharp margins is seen. The lesion was hypointense on T2 and showed moderate contrast enhancement on T1 weighted images post contrast. High signal intensity is seen in the silicone sensitive STIR sequence. The lesion was classified as a parasternal lymph node affected by silicone, i.e. a silicone lymphadenopathy. No changes of this lymph node were found in a follow up after 2 years.