Anaplastic Large Cell Lymphoma Arising in a Silicone Breast Implant Capsule: A Case Report and Review of the Literature

Abstract Anaplastic large cell lymphoma is a rare type of primary breast lymphoma. We report a case of anaplastic large cell lymphoma, T-cell phenotype, occurring in the periprosthetic capsule of a silicone breast prosthesis 9 years after implantation for augmentation mammoplasty. This case is unique for its unusual presentation.

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Composite breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) and extra-nodal marginal zone lymphoma (MZL) in the capsule of a silicone breast implant

Autoimmunity Reviews ◽

10.1016/j.autrev.2019.03.014 ◽

2019 ◽

Vol 18 (5) ◽

pp. 556-557 ◽

Cited By ~ 4

Author(s):

Lior Har-Shai ◽

Yaron Har-Shai ◽

Issa Metanes ◽

Yakov Schindler ◽

Edmond Sabo ◽

...

Keyword(s):

Anaplastic Large Cell Lymphoma ◽

Marginal Zone ◽

Cell Lymphoma ◽

Breast Implant ◽

Large Cell ◽

Marginal Zone Lymphoma ◽

Silicone Breast Implant ◽

Large Cell Lymphoma ◽

Nodal Marginal Zone Lymphoma

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Chromosome 20 loss is characteristic of breast implant–associated anaplastic large cell lymphoma

Blood ◽

10.1182/blood.2020005372 ◽

2020 ◽

Vol 136 (25) ◽

pp. 2927-2932

Author(s):

G. Tjitske Los-de Vries ◽

Mintsje de Boer ◽

Erik van Dijk ◽

Phylicia Stathi ◽

Nathalie J. Hijmering ◽

...

Keyword(s):

T Cell ◽

Anaplastic Large Cell Lymphoma ◽

Cell Lymphoma ◽

Breast Implant ◽

Breast Implants ◽

Large Cell ◽

Rare Type ◽

Anaplastic Lymphoma ◽

Chromosome 20 ◽

Large Cell Lymphoma

Abstract Breast implant–associated anaplastic large cell lymphoma (BIA-ALCL) is a very rare type of T-cell lymphoma that is uniquely caused by a single environmental stimulus. Here, we present a comprehensive genetic analysis of a relatively large series of BIA-ALCL (n = 29), for which genome-wide chromosomal copy number aberrations (CNAs) and mutational profiles for a subset (n = 7) were determined. For comparison, CNAs for anaplastic lymphoma kinase (ALK)− nodal anaplastic large cell lymphomas (ALCLs; n = 24) were obtained. CNAs were detected in 94% of BIA-ALCLs, with losses at chromosome 20q13.13 in 66% of the samples. Loss of 20q13.13 is characteristic of BIA-ALCL compared with other classes of ALCL, such as primary cutaneous ALCL and systemic type ALK+ and ALK− ALCL. Mutational patterns confirm that the interleukin-6–JAK1–STAT3 pathway is deregulated. Although this is commonly observed across various types of T-cell lymphomas, the extent of deregulation is significantly higher in BIA-ALCL, as indicated by phosphorylated STAT3 immunohistochemistry. The characteristic loss of chromosome 20 in BIA-ALCL provides further justification to recognize BIA-ALCL as a separate disease entity. Moreover, CNA analysis may serve as a parameter for future diagnostic assays for women with breast implants to distinguish seroma caused by BIA-ALCL from other causes of seroma accumulation, such as infection or trauma.

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Null-Type Anaplastic Lymphoma Kinase–Negative Anaplastic Large Cell Lymphoma Arising in a Silicone Breast Implant Capsule

Plastic & Reconstructive Surgery ◽

10.1097/prs.0b013e318213a1bd ◽

2011 ◽

Vol 127 (6) ◽

pp. 159e-162e ◽

Cited By ~ 17

Author(s):

Davide Lazzeri ◽

Tommaso Agostini ◽

Giordano Giannotti ◽

Giovanni Fanelli ◽

Livio Colizzi ◽

...

Keyword(s):

Anaplastic Large Cell Lymphoma ◽

Anaplastic Lymphoma Kinase ◽

Cell Lymphoma ◽

Breast Implant ◽

Large Cell ◽

Silicone Breast Implant ◽

Anaplastic Lymphoma ◽

Large Cell Lymphoma

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Complete Surgical Excision Is Essential for the Management of Patients With Breast Implant–Associated Anaplastic Large-Cell Lymphoma

Journal of Clinical Oncology ◽

10.1200/jco.2015.63.3412 ◽

2016 ◽

Vol 34 (2) ◽

pp. 160-168 ◽

Cited By ~ 184

Author(s):

Mark W. Clemens ◽

L. Jeffrey Medeiros ◽

Charles E. Butler ◽

Kelly K. Hunt ◽

Michelle A. Fanale ◽

...

Keyword(s):

Anaplastic Large Cell Lymphoma ◽

Cell Lymphoma ◽

Breast Implant ◽

Breast Implants ◽

Surgical Excision ◽

Large Cell ◽

Rare Type ◽

Complete Surgical Excision ◽

Large Cell Lymphoma

Purpose Breast implant–associated anaplastic large-cell lymphoma (BI-ALCL) is a rare type of T-cell lymphoma that arises around breast implants. The optimal management of this disease has not been established. The goal of this study is to evaluate the efficacy of different therapies used in patients with BI-ALCL to determine an optimal treatment approach. Patients and Methods In this study, we applied strict criteria to pathologic findings, assessed therapies used, and conducted a clinical follow-up of 87 patients with BI-ALCL, including 50 previously reported in the literature and 37 unreported. A Prentice, Williams, and Peterson model was used to assess the rate of events for each therapeutic intervention. Results The median and mean follow-up times were 45 and 30 months, respectively (range, 3 to 217 months). The median overall survival (OS) time after diagnosis of BI-ALCL was 13 years, and the OS rate was 93% and 89% at 3 and 5 years, respectively. Patients with lymphoma confined by the fibrous capsule surrounding the implant had better event-free survival (EFS) and OS than did patients with lymphoma that had spread beyond the capsule (P = .03). Patients who underwent a complete surgical excision that consisted of total capsulectomy with breast implant removal had better OS (P = .022) and EFS (P = .014) than did patients who received partial capsulectomy, systemic chemotherapy, or radiation therapy. Conclusion Surgical management with complete surgical excision is essential to achieve optimal EFS in patients with BI-ALCL.

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Breast implant-associated anaplastic large cell lymphoma: a case report with a history of spontaneously resolved late seroma

Archives of Aesthetic Plastic Surgery ◽

10.14730/aaps.2021.00136 ◽

2021 ◽

Vol 27 (4) ◽

pp. 143-148

Author(s):

Do Yeon Kim ◽

Joon Hur ◽

Woo Yeon Han ◽

Kyunghyun Min ◽

Jong Won Lee ◽

...

Keyword(s):

Anaplastic Large Cell Lymphoma ◽

Cell Lymphoma ◽

Breast Implant ◽

Large Cell ◽

Augmentation Mammoplasty ◽

Curative Surgery ◽

Current Case ◽

Late Seroma ◽

History Of ◽

Large Cell Lymphoma

We report a case of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), which had a history of spontaneous resorption of late seroma before diagnosis. A 47-year-old woman with a history of augmentation mammoplasty with round textured implants in January 2013 presented with a swelling on her right breast 6 years later, which was diagnosed as late seroma with suspected intracapsular rupture using ultrasonography (USG). Although aspiration was not done at the time of the initial USG, the seroma resolved spontaneously within weeks. A further workup proceeded with USG-guided aspiration followed by magnetic resonance imaging. Cytology of the aspirated fluid showed atypical cells. Cell block cytology and immunohistochemical staining confirmed the diagnosis of BIA-ALCL. En bloc resection with total capsulectomy and explantation was performed as curative surgery. Pathologic stage pT2N0M0 was confirmed and the patient was followed up without further treatment. Although the classic presentation of BIA-ALCL is known as late persistent seroma, an atypical manifestation such as spontaneous resorption may occur, as in the current case. A high level of suspicion and a thorough investigation with appropriate modalities will make it possible to detect this rare and potentially devastating disease.

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Fibrin‐associated diffuse large B‐cell lymphoma misdiagnosed as breast implant‐associated anaplastic large cell lymphoma

Histopathology ◽

10.1111/his.14372 ◽

2021 ◽

Author(s):

Mina Mansy ◽

Andrew C Wotherspoon ◽

Dima El‐Sharkawi ◽

David Cunningham ◽

Dorte Wren ◽

...

Keyword(s):

B Cell ◽

Anaplastic Large Cell Lymphoma ◽

Cell Lymphoma ◽

Breast Implant ◽

B Cell Lymphoma ◽

Large Cell ◽

Large B Cell Lymphoma ◽

Large Cell Lymphoma ◽

Large B Cell

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Primary Cutaneous CD30-Positive Anaplastic Large Cell Lymphoma in Childhood: Report of 4 Cases and Review of the Literature

Pediatric and Developmental Pathology ◽

10.1007/s10024-004-8087-6 ◽

2005 ◽

Vol 8 (1) ◽

pp. 52-60 ◽

Cited By ~ 39

Author(s):

Shimareet Kumar ◽

Stefania Pittaluga ◽

Mark Raffeld ◽

Michael Guerrera ◽

Nita L. Seibel ◽

...

Keyword(s):

T Cell ◽

Anaplastic Large Cell Lymphoma ◽

Cell Lymphoma ◽

Subcutaneous Tissue ◽

Pediatric Population ◽

Large Cell ◽

Lymphoid Cells ◽

Cell Phenotype ◽

Anaplastic Lymphoma ◽

Large Cell Lymphoma

We present the clinicopathologic findings in 4 children with primary cutaneous anaplastic large cell lymphoma (C-ALCL). The patients ranged in age from 13 months to 8 years, with 3 females and 1 male. All presented with a rapidly enlarging mass involving the skin and subcutaneous tissue. Histologic evaluation showed sheets of large pleomorphic lymphoid cells that were diffusely and strongly CD30+. Tumor cells were CD45+ in 1 of 4 cases. Cells were of T-cell phenotype, with variable positivity for CD3 (3 of 4 cases) and CD5 (2 of 4 cases). All 4 cases were positive for CD4 and clusterin. Staining for anaplastic lymphoma kinase was negative in all cases. No evidence of systemic involvement was noted at initial presentation or over a follow-up of 5 to 78 months, although 3 patients had cutaneous recurrences. Primary C-ALCL has only rarely been described in the pediatric population. The high-grade histologic appearance of this lymphoma belies its generally favorable clinical course and prognosis. Recognition of this entity and its differentiation from other T-cell lymphomas that secondarily involve the skin is important to avoid unnecessarily aggressive therapy in these children.

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