Breast Implant–Associated Anaplastic Large Cell Lymphoma

Pompeo, Fabio Santanelli di; Laporta, Rosaria; Sorotos, Michail; Napoli, Arianna Di; Giovagnoli, Maria Rosaria; Cox, Maria Christina; Campanale, Antonella; Longo, Benedetto

doi:10.1097/prs.0000000000001416

Cited by 48 publications

(39 citation statements)

References 26 publications

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“…Based on the presence of the CD30+ atypical cells and of the previous BI-ALCL diagnosis the seroma was intepreted as disease relapse. The immunophenotype of the BI-ALCL cases have been reported previously [17], [18] and is summarized in Table 1. All the cases showed a T-cell defective phenotype (Fig 3) with complete (case 1, 2, 3) or partial (case 4, 5) loss of CD3 expression.…”

Section: Resultsmentioning

confidence: 99%

Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma

et al. 2017

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Late breast implant seroma may be the presentation of a breast implant-associated anaplastic large cell lymphoma (BI-ALCL), which claims for a prompt recognition. However, BI-ALCL diagnosis on fine-needle aspiration (FNA) might be challenging for pathologists lacking experience with peri-implant breast effusions. Sixty-seven late breast implant seromas collected by FNA from 50 patients were evaluated by Papanicolaou smear stain and immunocytochemistry on cell blocks. A diagnostic algorithm based on the cellular composition, cell morphology and percentage of CD30+ cells was developed. Histological evaluation of the corresponding peri-prosthetic capsules was also performed. Most of the effusions (91% of the samples) were classified as reactive and 9% as BI-ALCL. In the BI-ALCL cases, medium-to-large atypical cells expressing CD30 represented more than 70% of the cellularity, whereas in in the reactive effusions CD30+ elements were extremely rare (<5%) and consisted of non-atypical elements. The reactive effusions were categorized into three patterns: i) acute infiltrate with prominent neutrophilic component (33% of the samples); ii) mixed infiltrate characterized by a variable number of neutrophils, lymphocytes and macrophages (30% of the samples); iii) chronic infiltrate composed predominantly of T lymphocytes or macrophages with only sporadic granulocytes (37% of the samples). The inflammatory cytological patterns were consistent with the histology of the corresponding capsules. Our results indicate that cytological analysis of late breast implant effusions, supported by the knowledge of the heterogeneous cytomorphological spectrum of late seromas, is a valuable approach for the early recognition of BI-ALCL.

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Section: Resultsmentioning

confidence: 99%

Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma

et al. 2017

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“…Opraviti je potrebno barvanje po Papanicolaou in Giemsi ter imunohistokemično testiranje. Diagnoza se postavi na podlagi imunohistokemičnega barvanja z označevalci CD30, ALK, CD3, CD4 in CD8 (18). Kim in sod.…”

Section: Obravnava Bolnicunclassified

“…predlagajo, da se opravi tudi pretočna citometrija (19). Pri pozitivnem izvidu se bolnik napoti na PET-CT ali CT slikanje in/ali biopsijo kostnega mozga, ker služi za ugotavljanje morebitne razširjenosti bolezni (18). Ob posvetu z onkologom je potrebno kirurško odstraniti vsadek in popolno odstraniti tkivno ovojnico z izrezom v zdravo ter prepoznati in odstraniti spremenjene bezgavke (19).…”

Section: Obravnava Bolnicunclassified

“…Santanelli di Pompeo in sod. predlagajo, da se bolnice, ki so imele bolezen omejeno na tkivno ovojnico, spremljajo prvi 2 leti na pol leta in kasneje enkrat letno do 5. leta po postavitvi diagnoze (18). Potrebno je opraviti klinični pregled, ultrazvočno preiskavo obeh dojk, aksilarnih in vratnih bezgavk, krvne preiskave in po presoji računalniškotomografsko slikanje (CT) celega telesa (18).…”

Section: Spremljanje Bolnic Po Zdravljenjuunclassified

“…Potrebno je opraviti klinični pregled, ultrazvočno preiskavo obeh dojk, aksilarnih in vratnih bezgavk, krvne preiskave in po presoji računalniškotomografsko slikanje (CT) celega telesa (18). Če je bolezen razširje-na, je potrebna napotitev k onkologu, ki določi režim spremljanja bolnic (18).…”

Section: Spremljanje Bolnic Po Zdravljenjuunclassified

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Anaplastični velikocelični limfom, povezan z vsadki dojk

Bajuk

Ahčan

2017

SlovMedJour

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IzvlečekPo svetu se vedno več žensk odloča za estetsko korekcijo dojk s silikonskimi vsadki in rekonstrukcijo dojk po zdravljenju karcinoma s tkivnim ekspandrom in silikonskim vsadkom. Ocene pravijo, da ima že več kot 10 milijonov žensk po svetu silikonske vsadke dojk. V literaturi je opisanih približno 200 posameznih primerov bolnic z anaplastičnim velikoceličnim limfomom (angl. anaplastic large cell lymphoma, ALCL), ki se povezuje s silikonskimi vsadki. Gre za redko bolezen, ki se po ocenah pojavlja pri 0,1-0,3/100.000 žensk s silikonskimi vsadki letno. Pri kliničnih znakih je potrebno pomisliti tudi na to, sicer zelo redko obliko ALCL. Bolnice so v povprečju stare 50 let. Pri njih se pozno po operaciji lahko pojavi povečanje dojke, bolečina in asimetrija. Pri diagnosticiranju sta pomembni ultrazvočna in citološka preiskava. Ultrazvočno lahko ugotovimo tekočinsko formacijo (serom) ali solidno tumorsko maso. Zdravljenje je individualno. Zaradi narave tumorja je v večini primerov potrebna odstranitev vsadka in popolna odstranitev tkivne ovojnice, katerima sta redko pridruženi kemo-in radioterapija. Petletno preživetje je odvisno od oblike tumorja in dobro korelira s prisotnostjo seroma ali tumorske mase. Pri seromu, ki je pogostejša oblika, je petletno preživetje 100-odstotno, medtem ko je pri solidni tumorski masi petletno preživetje 75-odstotno. Redkost bolezni predstavlja velik diagnostičen izziv, vendar je zgodnje odkrivanje in zdravljenje ključno za ozdravitev bolnic. AbstractAn increasing number of women worldwide decide for esthetic correction of breasts with silicone implants and post-cancer breast reconstruction with tissue expanders and silicone breast implants. It is estimated that more than 10 million women around the globe have them. There are approximately 200 known cases of patients with anaplastic large cell lymphoma (ALCL) linked with silicone breast implants reported in medical literature. ALCL is a rare disease with an annual incidence of 0.1-0.3/100 000 women with breast silicone implants. In the presence of clinical signs, physician should also consider this rare form of ALCL in differential diagnosis. Patients are on average 50 years old. Long after implantation surgery, the patient may experience breast swelling, pain and/or asymmetry. In diagnostics, ultrasound and cytological examination are required. During ultrasound examination fluid formation (seroma) or solid tumor mass can be detected. Treatment is individualized. Due to tumor nature, implant resection and total capsulectomy are usually indicated; also, chemo-and radiotherapy might rarely be required. Five-year survival rate depends on tumor form and correlates well with clinical findings of seroma or solid mass. In the more frequent form, seroma, five-year survival rate is 100 %, while in the case of solid tumor mass five-year survival rate is 75 %. The rarity of this disease makes it difficult to diagnose, but nevertheless, early detection and treatment are important for better recovery.

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