The American journal of the medical sciences
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Sudden death after subcutaneous injection of silicone has been described. However, there are no cases in the literature of clinically diagnosed noncardiogenic pulmonary edema. ⋯ The presence of birefringent particles in the alveolar macrophages implies entrance of this material into the vascular compartment, its embolization to the lung and migration across the damaged alveolar-capillary membrane. Large volume subcutaneous injections of silicone should be added to the differential diagnosis of the etiology of the adult respiratory distress syndrome.