Anaplastic Large Cell Lymphoma Associated With a Breast Implant Capsule: A Case Report and Review of the Literature

Abstract

Primary lymphomas of the breast are rare and predominately of B-cell phenotype. Anaplastic large cell lymphoma is a T-cell lymphoma that accounts for only 3% of all non-Hodgkin lymphomas. We present a rare case of primary anaplastic large cell lymphoma of the breast in association with a silicone breast implant capsule in a healthy 40-year-old woman. The patient had bilateral breast implants placed at 21 years of age and presented with painful bilateral breast contractures and associated breast asymmetry. Histology, immunohistochemistry, and T-cell gene rearrangement studies were supportive of a CD 30-positive ALK-1 negative anaplastic large cell lymphoma. This case represents the 14th reported case of primary breast lymphoma in association with breast prosthesis. Of interest is that 11 of these cases were T-cell lymphomas with 8 specifically of the CD30-positive anaplastic large cell lymphoma type. This rare case highlights the importance of histologic examination of breast capsule specimens.

Survival Signals and Targets for Therapy in Breast Implant–Associated ALK−Anaplastic Large Cell Lymphoma

“…As recently reported, breast implant-associated T-cell anaplastic large cell lymphomas are an emerging clinical entity (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). Three model cell lines, designated TLBR-1, -2, and -3, have been established from the primary tumor specimens from patients with a spectrum of indolent to aggressive BIA-ALCLs to facilitate studies of the etiology and potential therapy for these cancers.…”

“…TLBR-2 cells had a modal number of chromosomes of 76 and showed gains of chromosomes 1, 2, 5, 6, 10, 11, 14, 17, as well as clonal loss of one copy of chromosome 18, relative to a triploid genome. TLBR-3 cells showed a modal number of chromosomes of 81, gains of chromosomes X, 2,5,7,8,10,11,12,14,19,20,21, and 22, and clonal losses of one copy of chromosomes 9, 16, and 17, relative to a triploid genome. Cytogenetic analysis of the TLBR-1 cell line was reported previously (1).…”

“…Breast implant-associated (BIA) T-cell anaplastic large cell lymphoma (ALCL) is a recently recognized clinical entity, with 80 cases identified worldwide to date and four disease-specific fatalities (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15). BIA-ALCL presents commonly as a late seroma and/or tumor mass attached to the scar capsule containing malignant cells an average of 5.8 years after implant placement (range, 0.4-20 years; ref.…”

Anaplastični velikocelični limfom, povezan z vsadki dojk

“…anaplastic large cell lymphoma, ALCL) je skupina redkih CD30 + T-celičnih NHL. Nadalje jih delimo glede na prisotnost anaplastične limfomne kinaze (ALK) (2). Pojavlja se v treh oblikah: primarni sistemski ALCL, primarni kožni ALCL in s silikonskimi vsadki povezani ALCL.…”

“…Čeprav imajo bolniki s primarno sistemsko ALCL, ki imajo ALK-limfom, nizko 5-letno preživetje (40 %) imajo bolnice, pri katerih gre za s silikonskimi vsadki povezani ALCL, veliko boljše 5-letno preživetje (2,5). Preživetje je pri njih verjetno podobno preživetju bolnikov s primarnim kožnim ALCL (5).…”