Capsular synovial-like hyperplasia around mammary implants

Formation of a fibrous envelope around the implant, a so-called capsule with resultant contracture of the prosthesis, is an occasional complication of augmentation mammoplasty.

The capsulectomy specimen contains mature scar tissue with mononuclear cells, histiocytes, and foreign body giant cells.

Studies showed a striking form of papillary villous synovial-like hyperplasia similar to detritic synovitis, a form of proliferative synovitis caused by orthopedic prosthetic devices. There was an accompanying infiltration of the subcapsular surface by mononuclear cells, giant cells, and chronic inflammatory cells.

There is a striking similarity in the staining pattern of CSH, detritic synovitis, and normal synovium. CSH of the mammary prosthetic capsule could be pathophysiologically similar to proliferative synovitis.

References

 Capsular synovial-like hyperplasia around mammary implants similar to detritic synovitis. A morphologic and immunohistochemical study of 15 cases. Hameed MR, Erlandson R, Rosen PP. Am J Surg Pathol. 1995 Apr;19(4):433-8. PMID: 7694944