Laser-Raman microprobe identification of inclusions in capsules associated with silicone gel breast implants

Raman spectroscopy (the analysis of scattered photons after excitation with a monochromatic light source) provides a nondestructive method for identifying organic and inorganic materials on the basis of the molecule's characteristic spectrum of vibrational frequencies. Although the technique has been predominantly applied in sciences other than pathology, the recent advent of high-quality microscope optics coupled to optical Raman spectrometers (a variation known as a Raman microprobe) rendered this technique amenable to applications in human pathology. In the Raman microprobe, a laser beam is focused on a spot approximately 1 microm in diameter on the surface of the sample, e.g., tissue, and the scattered light is collected and analyzed. In this investigation, we used the Raman microprobe for the identification of foreign materials in breast implant capsular tissues. The characteristic silicone group frequencies associated with the silicon-oxygen stretch, the silicone-carbon stretch, the silicon-methyl and the methyl carbon-hydrogen stretch frequencies were used to identify polydimethylsiloxane and to define chemical differences among the various other implant-related inclusions. All of the inclusions were positively identified in a series of 44 capsules from silicone gel-filled implants: polydimethylsiloxane was found in 44 of 44 capsules surrounding silicone gel-filled implants; polyurethane was seen in 4 of 4 capsules around polyurethane foam-coated gel-filled implants; 4 of 4 capsules enveloping Dacron patch gel-filled implants revealed Dacron; and talc was identified in 8 of these 44 capsules. Raman microspectroscopy provides a rapid, accurate, and sensitive method for identifying inclusions associated with silicone and other implant materials in tissue.

[Carcinoma of the tonsils in pediatrics]

Tonsillar malignancies are frequently diagnosed as peritonsillar cellulitis or abscess until the tumor's growth is evident. The suspicion must arise when there is persistent and asymmetric tonsillar growth without fever. The presence of affected regional lymph nodes is of bad prognosis. A pediatric case is discussed, and recent reports are reviewed.

Primary osteosarcoma of the parotid gland

Four cases of primary osteosarcoma of the parotid gland, where these tumors rarely occur, are presented. This neoplasm may arise after radiation therapy, but the majority arise de novo. As a group, extraosseous osteogenic sarcomas are aggressive and lethal. Patients with these tumors have an average 5-year survival rate of 15.6%. Of the four patients reported on two died within 6 months to 3 years, one has lung metastases, and one has been lost to follow-up.