Chronic Pulmonary Silicone Embolism Syndrome (CPSE) is a chronic microembolic syndrome usually associated with breast implants.
Clinical features:
(1) presence of an implanted source of silicone
(2) development of progressive dyspnea
(3) intraparenchymal ground-glass opacities on imaging studies
(4) abnormal pulmonary function tests with reduction in vital capacity and diffusing capacity for carbon monoxide
(5) lung biopsy with granulomatous inflammation about foreign material
(6) demonstration of silicone microdroplets on scanning electron microscopy (SEM) with electron dispersion X-ray spectroscopy
The most common silicone source has been leakage from silicone-filled breast implants. Other sources have been:
(1) saline-filled breast implants (coming from a silicone gel coating the inside of the implant)
(2) cosmetic silicone injections, which may be done by unlicensed persons
