Fine needle aspiration biopsy of an enlarged axillary lymph node in a patient with an intact mammary prosthesis yielded a cellular sample in which there were numerous macrophages containing large cytoplasmic vacuoles, a picture suggestive of granulomatous inflammation of the foreign-body type. Subsequent excision of the lymph node confirmed the diagnosis. Analytical electron microscopy identified the foreign material as silicone. While the cytologic features of silicone lymphadenopathy are diagnostic in the appropriate clinical setting, excision of the lymph node may be advisable to exclude a concomitant malignant neoplasm.