Cytological features of breast implant‐associated anaplastic large cell lymphoma in pleural effusion

D’Alessandris, Nicoletta; Lucatelli, Pierleone; Tripodi, Domenico; Amabile, Maria Ida; Ascoli, Valeria

doi:10.1002/dc.24287

Cited by 6 publications

(4 citation statements)

References 24 publications

(47 reference statements)

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“…BIA-ALCL is supposed to be associated with chronic inflammation (11), which is further supported by scientific observations that chronic inflammation, induced by cytokines or ligands, triggers events that cause genetic instability leading to lymphoma transformation (12). In cases where this disease leads to the formation of only a periprosthetic fluid effusion, it usually follows an indolent clinical course and has an excellent prognosis compared to lymphoproliferative disease with mass formation or to systemic ALK-negative ALCL, which may have more aggressive pathways (13). Patients with BIA-ALCL, undergone total capsulectomy and breast implant remove, have been shown to present a better overall and disease-free survival with respect to patients treated with partial capsulectomy, systemic therapy, or radiotherapy (8).…”

Section: Discussionmentioning

confidence: 94%

Large cell anaplastic lymphoma associated with breast implant: a rare case report presentation and discussion of possible management

Tripodi¹,

Amabile²,

Varanese³

et al. 2021

Gland Surg

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Anaplastic large cell lymphomas (ALCL) are a rare type of primary breast lymphoma. The association between breast implants and ALCL was first described in 1997. Breast implant associated (BIA)-ALCL arises from the inflammatory T cells surrounding the fibrous capsule, and most tumors are in situ.Here we present the case of a 60-year-old woman with ALCL following bilateral silicone breast prosthesis implantation for aesthetic reason. The patient presented at our observation 7 years following the first surgery reporting a sport trauma in the right thoracic region with breast enlargement and tenderness, complaining breast pain at the palpation of the right breast. Imaging study showed a right fluid collection surrounding the affected breast implant. For this reason, the patient underwent bilateral complete capsulectomy (surgical specimen histologically analyzed and resulted negative for ALCL) and implantation of new breast silicone prosthesis. In 10 months, a progressive relapse of the symptoms with a right peri-implant fluid collection restauration was documented and bilateral surgical removal of breast prostheses with right peri-implant capsular biopsy were performed. The histological analysis of the peri-implant capsule laid for ALCL cellules and a new radical surgical excision of bilateral periprothesic capsule was performed followed by adjuvant radiotherapy for a skin relapse of the disease with a subsequent complete remission. No further relapse was observed afterwards. This clinical case raised a series of diagnostic and therapeutic issues highlighting similarities with previous BIA-ALCL reports, but also some peculiarities that deserve to be further investigated and described in order to make an early recognition of the disease for the proper management and treatment of the patient. Due to the rarity of these tumors, rapidly diagnosing a BIA-ALCL case, not neglecting other associated symptoms or signs, is essential to ensure timely and safe treatment.

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Section: Discussionmentioning

confidence: 94%

Large cell anaplastic lymphoma associated with breast implant: a rare case report presentation and discussion of possible management

Tripodi¹,

Amabile²,

Varanese³

et al. 2021

Gland Surg

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“…Pleural effusion post-breast augmentation surgery was first described by Stevens et al in 1987 [ 5 ]. Pleural effusion is one of the rarest complications for this type of surgery [ 5 , 6 ], and when found, underlying conditions such as anaplastic large cell lymphoma [ 7 , 8 ], implant rupture [ 5 ], or reactivation of latent infections [ 9 ] might explain the development of this complication. Shaik et al described a case without any underlying condition, and after a pathologic evaluation that included an examination of the pleural fluid, they associated the pleural effusion with an FBR due to the presence of silicone particles and mononuclear cells [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

Pleural Effusion as a Potential Complication of Foreign Body Reaction to Silicone Breast Implants: A Case Study

Abdeen¹,

Ortiz²,

Cala-Garcia³

et al. 2023

Cureus

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Breast augmentation surgery, like any other surgery, has potential complications, including the less common complication of pleural effusion. We present a unique case of a 44-year-old female who developed pleuritic chest pain and shortness of breath 10 days after her breast augmentation surgery, with no prior history of cardiac or autoimmune conditions. The temporal relationship between the surgery and the onset of symptoms suggested a possible direct link to the implants. Imaging showed a small- to moderate-sized left pleural effusion, and pleural fluid analysis revealed findings suggestive of a foreign body reaction (FBR), including evidence of mesothelial and inflammatory cells with a lymphocyte percentage of 44% and monocytes of 30%. The patient received intravenous steroids at a dose of 40 mg every eight hours for three days while hospitalized, followed by a tapered oral dose of steroids upon discharge, for over three weeks. Follow-up imaging studies showed complete resolution of the pleural effusion. The diagnosis of pleural effusion resulting from FBR to silicone gel-filled breast implants involves a clinical history, cytopathological examination, and the exclusion of other potential causes. This case highlights the importance of considering FBR as a potential cause of pleural effusion post-breast augmentation surgery.

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“…However, cases presenting with lymph node involvement (stage IIB-IV) are associated with reduced overall survival and can be fatal in some circumstances. 61 Fatalities have also occurred without lymph node involvement, when the lymphoma cells infiltrated through the chest wall, pleural space and mediastinum 62 .…”

Section: Breast Implant-associated Lymphomamentioning

confidence: 99%

Primary Lymphomas of the Breast: A Review

2022

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Cytological features of breast implant‐associated anaplastic large cell lymphoma in pleural effusion

Cited by 6 publications

References 24 publications

Large cell anaplastic lymphoma associated with breast implant: a rare case report presentation and discussion of possible management

Large cell anaplastic lymphoma associated with breast implant: a rare case report presentation and discussion of possible management

Pleural Effusion as a Potential Complication of Foreign Body Reaction to Silicone Breast Implants: A Case Study

Primary Lymphomas of the Breast: A Review

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