A proposal for pathologic processing of breast implant capsules in patients with suspected breast implant anaplastic large cell lymphoma

Lyapichev, Kirill A.; Piña‐Oviedo, Sergio; Medeiros, L. Jeffrey; Evans, Mark; Liu, Hui; Miranda, Alonso R.; Hunt, Kelly K.; Clemens, Mark W.; Stewart, John; Amin, Mitual; Quesada, Andres; Chai, Siaw Ming; Napoli, Arianna Di; Yoga, Arthy; Dave, Sanat K.; Wistuba, Ignacio I.; Wu, Yun; Bueso‐Ramos, Carlos E.; Schlette, Ellen; Ferrufino-Schmidt, María C.; Loghavi, Sanam; Khoury, Joseph D.; Young, Ken H.; Miranda, Roberto N.

doi:10.1038/s41379-019-0337-2

Cited by 29 publications

(24 citation statements)

References 17 publications

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“…An important and critical consideration for future studies is the adequate preservation of material for broad molecular testing. Two recent publications by Jaffe, et al and Lyapichev, et al outline key strategies in processing of the seroma fluid/effusion surrounding the implant and the handling of capsulectomy specimens following removal of implant(s) 33,34 …”

Section: Discussionmentioning

confidence: 99%

Next generation sequencing of breast implant‐associated anaplastic large cell lymphomas reveals a novel STAT3‐JAK2 fusion among other activating genetic alterations within the JAK‐STAT pathway

et al. 2021

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Breast implant associated anaplastic large cell lymphoma (BIA‐ALCL) is a distinct type of ALCL, and a new provisional entity by the 2016 revision of the World Health Organization (WHO) classification of tumors of hematopoietic and lymphoid tissues. In contrast to systemic and primary cutaneous ALCLs, BIA‐ALCLs have been genetically characterized by the absence of fusions and frequent activation of the JAK‐STAT3 pathway through mutations in JAK1 and STAT3. In this study, we report the results of the genetic profiling of 9 BIA‐ALCL cases supporting the role of the JAK‐STAT pathway activation in this entity, including the identification of an activating STAT3‐JAK2 fusion similar to those recently reported in T‐cell lymphoproliferative disorders of the gastrointestinal tract. To our knowledge, this is the first fusion reported in BIA‐ALCL, providing further insight into the overall genetic landscape of this rare entity as well as uncovering potential options for targeted therapy in cases with advanced disease.

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Section: Discussionmentioning

confidence: 99%

Next generation sequencing of breast implant‐associated anaplastic large cell lymphomas reveals a novel STAT3‐JAK2 fusion among other activating genetic alterations within the JAK‐STAT pathway

et al. 2021

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“…There have been many incidences where the diagnostic studies were not properly performed or interpreted leading to a missed or late diagnosis. Patient Advocates recommend patients review their pathology report and (CD30 immunohistochemistry) to ensure accurate evaluation was performed for both fluid and capsule tissue after biopsies and surgery (29). Communication is essential between surgeons and pathologists, to make sure the type of evaluation is clear, particularly when all parties may be unfamiliar with the disease.…”

Section: Diagnosis and Treatmentmentioning

confidence: 99%

Advising patients about breast implant associated anaplastic large cell lymphoma

Parham¹,

Hanson²,

Butler³

et al. 2021

Gland Surg

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The United States Food and Drug Administration (FDA) recently recognized the necessity for improved patient education and public awareness of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). BIA-ALCL is an uncommon T-cell lymphoma that can arise years after placement of a textured breast implant or tissue expander. Patients and providers would greatly benefit from a broader awareness of BIA-ALCL and how it presents with both common and rare symptoms. Disease awareness can be improved with specific steps moving forward. This includes improved counseling about annual recommendations from the FDA, standard of care guidelines, current estimates of disease prevalence, and manufacturer-specific risk for developing the malignancy. Informed consent for implant-based breast surgery should include a discussion of BIA-ALCL, symptoms, inherent risks and alternatives. Consideration should be given for reasonable efforts to retroactively contact patients with textured implants to inform them of recent regulatory actions as well as the risk of developing the disease and the signs and symptoms to watch for. Where risk can be reduced, all steps should be taken to ensure patient safety. In keeping with our commitment to patient safety, the strategies moving forward for implant-based breast surgery should be marked by patient awareness, physician vigilance, and defined by evidence-based diagnosis and treatment.

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“…Fixation and mapping of the capsulectomy specimen to select multiple representative sections are advised to assess for microscopic tumor involvement and capsular invasion. 28,29 Based on the status of capsular involvement by tumor cells, the pathologic tumor stages are defined as T0 to T4. 29 Tumors extending beyond the capsule and regional lymph nodes and/or incomplete capsulectomy are associated with worse prognosis.…”

Section: Breast Implant-associated Alclmentioning

confidence: 99%

“…28,29 Based on the status of capsular involvement by tumor cells, the pathologic tumor stages are defined as T0 to T4. 29 Tumors extending beyond the capsule and regional lymph nodes and/or incomplete capsulectomy are associated with worse prognosis. 30 Although these cases are rarely tested, the majority of tested cases show a complex karyotype and carry monoclonal TCRG and/or TCRB rearrangements.…”

Section: Breast Implant-associated Alclmentioning

confidence: 99%

Update on the Classification of and Diagnostic Approaches to Mature T-Cell Lymphomas

Zhang

Zhou

Han

et al. 2021

Archives of Pathology &Amp; Laboratory Medicine

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Context.— In the 2017 revised World Health Organization classification of tumors of hematopoietic and lymphoid tissues, some mature T-cell lymphomas are reclassified and a few new provisional entities are established based on new data from clinical and laboratory studies. T follicular helper cell lymphoma is identified by T follicular helper cell markers. Anaplastic large cell lymphoma, ALK negative, is a better-defined entity based on genetic abnormalities, and breast implant–associated anaplastic large cell lymphoma is recognized as a provisional entity. The gastrointestinal T-cell lymphomas are reclassified, with addition of a new provisional entity, indolent T-cell lymphoproliferative disorder of the gastrointestinal tract, characterized by an indolent clinical course. Objective.— To review the diagnostic approaches of reclassified and newly established entities of mature T-cell lymphomas, focusing on significant immunophenotypic features and molecular genetic abnormalities. Relevant new discoveries after the publication of the 2017 World Health Organization classification are included. Data Sources.— Information from the literature most relevant to 2017 World Health Organization revised classification and publications after 2016. Conclusions.— Incorporating clinical, morphologic, and immunophenotypic features usually provides sufficient evidence to reach a preliminary diagnosis of mature T-cell lymphoma. Molecular genetic studies can be very helpful for the final diagnosis and classification, especially in challenging cases. Some molecular genetic features have been found in breast implant–associated anaplastic large cell lymphoma, distinct from anaplastic large cell lymphoma, ALK negative. Immunohistochemical staining of 4 markers may enable further subtyping of peripheral T-cell lymphomas.

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A proposal for pathologic processing of breast implant capsules in patients with suspected breast implant anaplastic large cell lymphoma

Cited by 29 publications

References 17 publications

Next generation sequencing of breast implant‐associated anaplastic large cell lymphomas reveals a novel STAT3‐JAK2 fusion among other activating genetic alterations within the JAK‐STAT pathway

Next generation sequencing of breast implant‐associated anaplastic large cell lymphomas reveals a novel STAT3‐JAK2 fusion among other activating genetic alterations within the JAK‐STAT pathway

Advising patients about breast implant associated anaplastic large cell lymphoma

Update on the Classification of and Diagnostic Approaches to Mature T-Cell Lymphomas

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