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

Mansy, Mina; Wotherspoon, Andrew; El‐Sharkawi, Dima; Cunningham, David; Wren, Dörte; Sharma, Bhupinder; MacNeill, Fiona; Attygalle, Ayoma

doi:10.1111/his.14372

Cited by 9 publications

(18 citation statements)

References 5 publications

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“…Nineteen of them developed in breast implants. 14,[26][27][28][29][30][31][32] Eight cases developed in thrombus, vegetation, or hematoma associated with an intravascular implant (7 being arterial graft, 8,10,20,22 1 being a bovine mitral valve 22 ). The 2 remaining cases developed after knee replacement.…”

Section: Discussionmentioning

confidence: 99%

EBV-negative Fibrin-Associated Large B-Cell Lymphoma Arising in Thyroid Hyperplastic Nodule: Report of a Case and Literature Review

Cheuk

Chan

2023

Int J Surg Pathol

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Fibrin-associated large B-cell lymphoma is a rare microscopic-sized tumor, typically representing an unexpected finding at sites rich in chronic fibrin deposition. It is associated with Epstein-Barr virus, and has been reported to occur in a wide variety of anatomic sites and clinical scenarios. We report a case arising in a thyroid hyperplastic nodule, only the second case reported in this location. Notably, this is only the fourth case of fibrin-associated large B-cell lymphoma that is not associated with Epstein-Barr virus. We provide a literature review on the clinico-pathological characteristics and outcome of this newly characterized indolent lymphoma type, which has only recently been separated out from the pathologically similar but highly aggressive large B-cell lymphoma associated with chronic inflammation.

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Section: Discussionmentioning

confidence: 99%

EBV-negative Fibrin-Associated Large B-Cell Lymphoma Arising in Thyroid Hyperplastic Nodule: Report of a Case and Literature Review

Cheuk

Chan

2023

Int J Surg Pathol

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“…polyclonal pattern in TRG targets (TRB not analyzed). T3N0M0 Capsulectomy CR (Follow-up 24 months) Malata M. C., et al [ 13 ] 51 21 No FA-DLBCL HIV CD30 + , CD45 + , PAX5 + , CD79A + , BCL2 + , MUM1 + , BCL6 + , CD10 - , CD138 - CD30 + , CD45 + , CD3 - , CD5 - , CD2 - , ALK - CD138 - , HHV8 - , MIB-1 proliferation index: 80% NA NA T2/3N0M0 Small volume axillary nodes on CT Capsulectomy CR (Follow-up 24 months) Khoo C., et al [ 14 ] 70 9 No FA-DLBCL Unknown CD30 + , CD45 + , CD79A + , CD20 + , PAX5 + , BCL6 + , MUM1 + , PD-L1 + (SP142 clone), CD10 - CD45 + , CD30 + , CD3 - , CD2 - , CD4 - , CD5 - , CD7 - , CD8 - , TIA1 - , perforin - , Granzyme B - , ALK - CD68 - , AE1 - /AE3 - , Cam 5.2 - , EMA - , HHV-8 - NA Monoclonal peak in IHC rearrangement T3N0M0 Capsulectomy CR (Follow-up 12 months) Mescam L., et al [ 10 ] 72 NA No intermediate features between CI- and FA-DLBCL Unknown CD30 ...…”

Section: Discussion and Overview Of The Literaturementioning

confidence: 99%

“… + Time I->D: from implant to diagnosis ++ EBV latency patterns by immunohistochemmistry: 0/I = LMP1- and EBNA2-; II = LMP1+ and EBNA2-; latency III = LMP1+ and EBNA2+ +++ Following staging guidelines described in Clemens et al, 2019 [ 3 ] * Review of 7 non-invasive EBV+ BIA-DLBCL including 2 cases from Khoo C., et al [ 14 ] and Mescam L., et al [ 10 ], also shown in this table ** relapse in the ipsilateral axilla 24 months after chemotherapy for which patient received chemo-and radiotherapy, after which, patient was in complete remission. Subsequently, the patient had a second lymphoma relapse presenting as a chest wall mass 21 months after chemotherapy, for which she received Chemotherapy.…”

Section: Discussion and Overview Of The Literaturementioning

confidence: 99%

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

et al. 2023

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Breast-implant associated (BIA) lymphoma is an infrequent type of cancer occurring in the fluid and fibrous capsule around a textured breast implant. Recently, both the 2022 WHO 5th edition classification of Haematological tumours (WHO HAEM5) and 2022 International Consensus Classification of Mature Lymphoid Neoplasms (22ICC), recognized breast implant-associated Anaplastic Large Cell Lymphoma (BIA-ALCL) as a definitive entity, defined as a mature CD30-positive T-cell lymphoma, confined by a fibrous capsule, in a breast implant setting. Only few B-cell lymphomas have been reported in the literature to be associated with breast implants. Here we report two EBV-positive Diffuse Large B-cell lymphomas (EBV + DLBCL) in relation to a breast implant, both expressing CD30 as well as EBV latency type 3. Both lesions were considered as DLBCL associated with chronic inflammation (CI-DLBCL), but one presented as a 7 cm solid mass, while the other presented as a fibrin-associated DLBCL (FA-DLBCL) in an HIV patient. Clinically, both are in complete remission 6 months or longer after capsulectomy and graft removal, without additional chemotherapy.Such cases, characterized by large CD30-positive cells, can easily be misdiagnosed as BIA-ALCL if the cell of origin is not further established. Therefore, a diagnostic panel including lineage-specific B-and T-cell markers and EBER in situ hybridization is essential to recognize this rare entity, to understand lymphomagenesis, to predict outcome and to define clinical approach.

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“…Virale Infektionen sind für 15-20 % aller menschlicher Tumoren verantwortlich [43] In den letzten Jahren wurden zusätzlich zum BIA-ALCL auch implantatassoziierte, diffus großzellige B-Zell-Lymphome (DLBCL) beschrieben, wie das brustimplantatassoziierte, EBV-positive, diffus großzellige B-Zell-Lymphom [44,45,46,47]. Diese sind meist negativ für ALK, CD2, CD3, und B-Zell-Marker [48], jedoch u. a. CD20- [44,47,48,49], CD5-, BCL-2-, CD21-, CD23-, IgD-, IgMpositiv [49], im Falle von EBV-positiven, diffus großzelligen B-Zell-Lymphomen CD20-, CD30-, CD79a-, MUM1-und PAX-5-positiv [44,47,48] und ähnlich zum BIA-ALCL in den meisten Fällen mit texturierten Implantaten assoziiert [45,47]. In einem Fall wurde ein DLBCL jedoch auch nach Implantation eines glattwandigen Implantats beschrieben [50].…”

Section: Weitere Brustimplantatassoziierte Tumorenunclassified

Breast Implant-Associated Tumors

Fritschen

Kremer

Prantl

et al. 2023

Geburtshilfe Frauenheilkd

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In addition to anaplastic large T-cell lymphomas (BIA-ALCL), other implant-related tumors have been described for some years. Squamous cell carcinoma (SSC) and B-cell lymphomas occurred in very rare cases. The unexplained pathogenesis as well as the unclear individual risk profile is an ongoing source of uncertainty for patients and physicians. The pathogenesis of the tumors is still largely not understood. While BIA-ALCL occurs more frequently with textured breast implants, other tumors were also observed with smooth implants and at other implant sites. Multiple potential mechanisms are discussed. It is suspected that the etiology of a chronic inflammatory response and subsequently immunostimulation is multifactorial and appears to play a key role in the malignant transformation. Since there are currently no sufficiently valid data for a specific risk assessment, this must be done with caution. This article presents the incidence, pathogenesis, as well as the level of evidence according to the current state of knowledge, and evaluates and discusses the current literature.

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

Cited by 9 publications

References 5 publications

EBV-negative Fibrin-Associated Large B-Cell Lymphoma Arising in Thyroid Hyperplastic Nodule: Report of a Case and Literature Review

EBV-negative Fibrin-Associated Large B-Cell Lymphoma Arising in Thyroid Hyperplastic Nodule: Report of a Case and Literature Review

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

Breast Implant-Associated Tumors

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