Manejo del seroma crónico en pacientes con implantes de mama en relación con el diagnóstico de linfoma anaplásico de células gigantes

Abstract

INTRODUCCIÓN L os primeros registros en la literatura sobre el linfoma anaplásico de células gigantes se tienen en la década de los noventa. En la revista de nuestra especialidad, el primer caso aparece reportado en el año de 1997. 1,2 Desde entonces hemos visto un incremento en la incidencia, junto con un mayor reporte y conocimiento de esta patología. En 2016, revisamos la literatura y encontramos 80 casos. 3 De acuerdo con el Global Task Force contamos actualmente con más de 600 casos; posiblemente esta cifra aumente, por lo que debemos tener mayor conocimiento del problema. Esta patología ha causado un alto impacto en las autoridades sanitarias, sociedades médicas, medios de comunicación y pacientes. Además, la información que se genera con frecuencia es controvertida y no dx.doi.org/10.35366/CP191H Manejo del seroma crónico en pacientes con implantes de mama en relación con el diagnóstico de linfoma anaplásico de células gigantes Management of chronic seroma in patients with breast implants in relation to the diagnosis of anaplastic lymphoma of giant cells

Unilateral refractory late periprosthetic breast implant seroma and biofilm

“…Biofilm formation is more common in textured implants due to the higher bacterial load and greater surface area, leading to chronic inflammation and increased T cell response which potentially mutate and lead to BIA‐ALCL 9,10 . One theory proposes that a biofilm formation is associated with host factors and their immune response, activating T‐lymphocytes and triggers polyclonal proliferation and in rare cases monoclonal proliferation and the development of BIA‐ALCL 10 .…”

“…Biofilm formation is more common in textured implants due to the higher bacterial load and greater surface area, leading to chronic inflammation and increased T cell response which potentially mutate and lead to BIA‐ALCL 9,10 . One theory proposes that a biofilm formation is associated with host factors and their immune response, activating T‐lymphocytes and triggers polyclonal proliferation and in rare cases monoclonal proliferation and the development of BIA‐ALCL 10 . In this specific case even though the cytology results show no evidence of BIA‐ALCL, the possibility of a biofilm formation being associated with BIA‐ALCL emphasises the importance of best practice intraoperatively including removal of implant, biofilm and total capsulectomy 11 .…”

“…9,10 One theory proposes that a biofilm formation is associated with host factors and their immune response, activating T-lymphocytes and triggers polyclonal proliferation and in rare cases monoclonal proliferation and the development of BIA-ALCL. 10 In this specific case even though the cytology results show no evidence of BIA-ALCL, the possibility of a biofilm formation being associated with BIA-ALCL emphasises the importance of best practice intraoperatively including removal of implant, biofilm and total capsulectomy. 11 Ultimately this would prevent T cell hyperplasia and reduce cell transformation and development of malignancy, that is, BIA-ALCL.…”