CTICasesDiffuse Alveolar Damage (DAD) due to Silicone Embolization
Imaging findings
Initial radiographs showed diffuse ground-glass opacities progressing to a diffuse alveolar damage/ARDS pattern, requiring intubation. Subsequent CT one month later revealed organizing diffuse alveolar damage with dilated airways and coarse reticulation. The patient had a history of silicone injection into pectoralis muscles for gender reassignment. Autopsy confirmed silicone embolization.
Key takeaways
Silicone embolization syndrome can manifest as severe acute lung injury, leading to a diffuse alveolar damage (DAD) and ARDS-like pattern, which can be distinct from the peripheral ground-glass pattern. The diagnosis can be challenging due to delayed history disclosure and a prolonged clinical course, often requiring autopsy for definitive confirmation.
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