Silicone lymphadenopathy mimicking a lymphoma in a patient with a metatarsophalangeal joint prosthesis.

With lymph node enlargement, the possibility of a malignant process such as metastatic carcinoma or lymphoma needs to be excluded. This report describes a 47 year old woman with inguinal lymph node enlargement initially suspicious for lymphoma. Fine needle aspiration findings favoured reactive hyperplasia, but a malignant process could not be excluded. The final histological diagnosis was a foreign body granulomatous inflammatory response as a result of regionally disseminated silicone particles from an over looked metatarsophalangeal joint prosthesis. Because of the large number of joint prostheses world wide, it should be kept in mind that migration of wear particles can create granulomatous inflammation and node enlargement.

[Cytology of fluids of articular puncture]. / Cytologie des liquides de ponction articulaire.

Cytologic examination of synovial fluid has been shown to be useful in the diagnosis of various joint diseases. Few pathologists are proficient in the interpretation of the occasional synovial fluids that most cytology laboratories receive. The majority of the aspirated synovial fluids are sent only for bacterial culture and valuable information from the cytologic examination is missed. We describe how pathologists should perform analysis of these fluids and what kind of information they can provide to the physician.