Complications of Silicone Implant

To the Editor.— We read the recent article inThe Journalreviewing complications of long-term silicone implant arthroplasty 1 and would like to mention our report of silicone lymphadenopathy. 2 Our case was unique in the association of necrobiotic rheumatoid nodules with silicone particles within enlarged axillary lymph nodes. This association suggested to us that the silicone particles might be inciting the rheumatoid nodules in a manner analogous to the relationship between silica and rheumatoid nodules in the lung. 3 Nalbandian et al 1 referred to an isolated report of immunoblastic lymphoma associated with superimposed silicone particles. A large-cell lymphoma has subsequently developed in our patient also, with silicone particles identifiable within the lymphomatous infiltration. We are, however, like Nalbandian et al, 1 inclined to attribute this concurrence to the known increased risk of lymphoma in rheumatoid arthritis rather than to invoke silicone particles as an etiologic factor. We are