Breast implant associated EBV-positive Diffuse Large B-cell lymphoma: an underrecognized entity?

Vets, Johanna; Marcelis, Lukas; Schepers, Charlotte; Dorreman, Yaliva; Verbeek, Sanne; Vanwalleghem, Lieve; Gieraerts, Katrien; Meylaerts, L; Lesaffer, Jan; Devos, Helena; Put, Natalie; Snauwaert, Sylvia; Paepe, Pascale De; Tousseyn, Thomas

doi:10.1186/s13000-023-01337-5

Cited by 6 publications

(4 citation statements)

References 20 publications

(35 reference statements)

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“…It appears to be a growth induced by a state of regional immunosuppression 13 . Only 60 cases have been described in the literature, mainly in relation to kneeprosthetic replacements, mammary implants 14 and cardiac myxomas 15 as mentioned above. No such circumstances were present in our patient.…”

Section: Discussionmentioning

confidence: 99%

Splenic cyst deroofing complicated with B lymphoma

De Quirós,

Jiménez-Romero,

Suárez

et al. 2024

Preprint

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Background: Splenic cysts are uncommon and very rarely malignant therefore their treatment isn’t standardised. In case of symptomatic cysts different surgical approaches have been suggested. Primary malignant lymphoma of the spleen comprises less than 1% of non-Hodgkin’s lymphomas. To our knowledge, only 203 cases of splenic large B-cell lymphoma (LBCL) have been reported to date and only 2 of them were fibrin-associated splenic cysts. Case presentation: 27-year-old model with a 19x13cm splenic cyst without data of malignancy in the preliminary study and therefore treated with laparoscopic deroofing. After histological diagnosis of LBCL with a fibrin/EVB-associated splenic pseudocyst the patient received 4 cycles of Rituximab and a laparoscopic splenectomy was performed due to resurgence of the pseudocyst. No evidence of malignancy has been found in controls performed after the splenectomy. Discussion and Conclusions: the value of tumour markers and radiology for diagnosis of splenic cysts is put into question. Only 60 cases of Fibrin-associated LBCL (FA-LBCL) have been described in the literature therefore there are no treatment guidelines for them even though surgery together with systemic treatment has been the prevalent route with good results in most cases.

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Section: Discussionmentioning

confidence: 99%

Splenic cyst deroofing complicated with B lymphoma

De Quirós,

Jiménez-Romero,

Suárez

et al. 2024

Preprint

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“…Recently, a novel lymphoma type was reported, the breast implant-associated EBV-positive DLBCL; it has not been determined whether this is a separate entity or can be categorized into the EBV-positive DLBCL group [ 66 ].…”

Section: Viral Infectionsmentioning

confidence: 99%

The Possible Role of Pathogens and Chronic Immune Stimulation in the Development of Diffuse Large B-Cell Lymphoma

Gergely,

Udvardy,

Illes

2024

Biomedicines

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Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin lymphoma. The disease is very heterogeneous, with distinct genetic alterations in subtypes. The WHO 2022 5th edition classification identifies several minor groups of large B-cell lymphoma where the pathogenetic role of viruses (like EBV and HHV-8) is identified. Still, most cases fall into the group of DLBCL not otherwise specified (NOS). No review focuses only on this specific lymphoma type in the literature. The pathogenesis of this entity is still not fully understood, but several viruses and bacteria may have a role in the development of the disease. The authors review critical pathogenetic events in the development of DLBCL (NOS) and summarize the data available on several pathogenetic viruses and bacteria that have a proven or may have a potential role in the development of this lymphoma type. The possible role of B-cell receptor signaling in the microenvironment is also discussed. The causative role of the Epstein–Barr virus (EBV), human herpesvirus-8 (HHV-8), Hepatitis C virus (HCV), human immunodeficiency virus (HIV), Hepatitis B virus (HBV), and other viruses are explored. Bacterial infections, such as Helicobacter pylori, Campylobacter jejuni, Chlamydia psittaci, Borrelia burgdorferi, and other bacteria, are also reviewed.

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“…In a porcine model, Jacombs et al observed that textured implants that were injected with Staphylococcus epidermidis produced an average bacterial load that was 20 times higher than that of smooth implants [33]. A correlation between the BIA-ALCL and the Ebstein-Barr Virus has also been hypothesized [34]. In recent times, there has been an increased focus on the genetics of BIA-ALCL, as understanding the alterations underlying the disease process could aid in disease prognosis and customized patient care.…”

Section: Clinical Aspectsmentioning

confidence: 99%

BIA-ALCL and BIA-SCC: Updates on Clinical Features and Genetic Mutations for Latest Recommendations

D’Orsi,

Giacalone,

Calicchia

et al. 2024

Medicina

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Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) and Breast Implant-Associated Squamous Cell Carcinoma (BIA-SCC) are emerging neoplastic complications related to breast implants. While BIA-ALCL is often linked to macrotextured implants, current evidence does not suggest an implant-type association for BIA-SCC. Chronic inflammation and genetics have been hypothesized as key pathogenetic players, although for both conditions, the exact mechanisms and specific risks related to breast implants are yet to be established. While the genetic alterations in BIA-SCC are still unknown, JAK-STAT pathway activation has been outlined as a dominant signature of BIA-ALCL. Recent genetic investigation has uncovered various molecular players, including MEK-ERK, PI3K/AKT, CDK4-6, and PDL1. The clinical presentation of BIA-ALCL and BIA-SCC overlaps, including most commonly late seroma and breast swelling, warranting ultrasound and cytological examinations, which are the first recommended steps as part of the diagnostic work-up. While the role of mammography is still limited, MRI and CT-PET are recommended according to the clinical presentation and for disease staging. To date, the mainstay of treatment for BIA-ALCL and BIA-SCC is implant removal with en-bloc capsulectomy. Chemotherapy and radiation therapy have also been used for advanced-stage BIA-ALCL and BIA-SCC. In-depth characterization of the tumor genetics is key for the development of novel therapeutic strategies, especially for advanced stage BIA-ALCL and BIA-SCC, which show a more aggressive course and poor prognosis.

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Breast implant associated EBV-positive Diffuse Large B-cell lymphoma: an underrecognized entity?

Cited by 6 publications

References 20 publications

Splenic cyst deroofing complicated with B lymphoma

Splenic cyst deroofing complicated with B lymphoma

The Possible Role of Pathogens and Chronic Immune Stimulation in the Development of Diffuse Large B-Cell Lymphoma

BIA-ALCL and BIA-SCC: Updates on Clinical Features and Genetic Mutations for Latest Recommendations

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