Breast Implant–associated Anaplastic Large Cell Lymphoma

Kim, Benjamin; Predmore, Zachary; Mattke, Soeren; Busum, Kristin Van; Gidengil, Courtney A.

doi:10.1097/gox.0000000000000268

Cited by 60 publications

(19 citation statements)

References 52 publications

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“…The presence of any sort of effusion beyond 1 year after implant surgery is relatively rare, estimated at less than 1%, and any Blate-onset seroma^formation should raise the suspicion of BIA-ALCL [9]. Any patient presenting with recurrent seroma 6 months or more after implantation should undergo aspirate analysis without delay [10].…”

Section: Discussionmentioning

confidence: 99%

“…Micrometastatic lymphoma disease may be present but undetected at initial diagnosis. Perhaps capsulectomy is not a sufficiently aggressive treatment for BIA-ALCL, as it would not eliminate micrometastases [16]; however, current expert opinion firmly disagrees with an obligatory chemo-/radiotherapeutic treatment of all patients with BIA-ALCL [9].…”

Section: Discussionmentioning

confidence: 99%

“…In addition, clinicians and pathologists should include this entity in the differential diagnosis of a lesion appearing in patients with breast implants. Although most cases have an indolent clinical course [9], the variety of presentations defined as Bseroma^vs. Bcapsular involvementê mphasizes the importance of investigating a definitive method of diagnosis, management, and treatment of this disease [18].…”

Section: Discussionmentioning

confidence: 99%

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Breast implant-associated anaplastic large cell lymphoma vs. anaplastic large cell lymphoma in a patient with breast implant effusion history: a diagnostic dilemma

et al. 2016

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Breast implant-associated anaplastic large cell lymphoma is a rare tumor, affecting patients in the post-breast implant setting, first reported in 1997. We report an extraordinary case of anaplastic large cell lymphoma presenting not as a breast mass but as a spinal tumor, and thus in distant disease stage if considered breast implant-associated. A 35-year-old female, who had undergone bilateral breast augmentations over a decade ago and recent implant removal, complained of back pain with an anterior thoracic projection bilaterally. Clinical and radiological work-up revealed pleural nodules, T6 vertebral/costal infiltration, enlarged left axillary lymph nodes, and extradural spinal masses bilaterally, from which tumor samples were studied morphologically and immunohistochemically. There was diffuse infiltration by enlarged, neoplastic lymphoid cells with eosinophilic cytoplasm and large, irregular, partially embryoid, or multi-lobulated nuclei with distinctive nucleoli. The findings were interpreted as soft tissue and bone infiltration by an aggressive CD30 + , ALK − anaplastic large cell lymphoma. Since cytological or histological analysis on the initial peri-prosthetic inflammation tissue and effusion was not performed, the diagnosis of breast implant-associated anaplastic large cell lymphoma is critically difficult. If the clinical setting is not regarded coincidental, then it strongly favors the diagnosis of what could be a rare aggressive undetected form of breast implant-associated anaplastic large cell lymphoma. If so, the importance of awareness of this probable clinical entity among female patients and their surgeons as well as of the recognition and cytological study of peri-prosthetic effusions is emphasized, so as to enable early detection of a possible lymphomatous proliferation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Breast implant-associated anaplastic large cell lymphoma vs. anaplastic large cell lymphoma in a patient with breast implant effusion history: a diagnostic dilemma

et al. 2016

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“…Patients presenting with disseminated disease are at higher risk for recurrence. If complete excision is not possible in this population, then neoadjuvant radiation therapy should be considered (Horwitz et al, 2018;Kim, Predmore, Mattke, van Busum, & Gidengil, 2015) Advanced, widespread BIA-ALCL is rare and there is currently no standard of care for patients who fall in this category (Ferrufino-Schmidt et al, 2018). Patients with extensive disease have most often been treated with regimens similar to those for patients with systemic ALK-negative ALCL.…”

Section: Treatmentmentioning

confidence: 99%

Breast Implant–Associated Anaplastic Large Cell Lymphoma: What We Know

Nek

Coggins

2019

JADPRO

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Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare peripheral T-cell lymphoma, first reported in 1997. It is pathologically confirmed as a CD30-positive, anaplastic lymphoma kinase (ALK)-negative ALCL by immunohistochemistry. Unlike systemic ALK-negative ALCL, breast implant-associated disease has a much more favorable prognosis overall. In most cases, BIA-ALCL will present with delayed seroma more than 1 year after breast implantation indicated for either cosmetic or reconstructive purposes. The average onset of seroma presentation is 8 to 9 years after implantation. Breast implant-associated anaplastic large cell lymphoma may arise in one of two distinct forms: either in situ or infiltrative disease. In situ disease is confined within a seroma, while infiltrative disease may present with lymph node involvement either with or without palpable breast mass or tumor. Infiltrative disease has an overall worse prognosis in regards to disease-related mortality, up to 40% within 2 years. Appropriate pathological consultation with an experienced hematopathologist and oncologist is imperative when making a diagnosis of BIA-ALCL. There are several theorized risk factors associated with the disease; however, the exact pathophysiology is not yet known. Our objective in writing this review article is to provide an overview of what we know about the epidemiology, disease characteristics, and current management strategies. In doing so, we aim to bring awareness and familiarity to the advanced practitioner population in recognizing and treating BIA-ALCL.

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“…1 in 1 Million pro Jahr nach Einsetzen des Brustim plantats niedrig; die überwiegende Zahl der BIA-ALCL war ALK-negativ. Das diagnostische und therapeutische Vorgehen basierend auf retrospektiven Daten, wurde in einer Konsensus konferenz[83] diskutiert und umfasst bisher die gezielte diagnostische Abklärung (Punktion mit Zytologie, ggf. Biopsie, Bildgebung) bei Auftreten von Seromen >12 Monate nach Einset zen von Implantaten, sowie bei positiver Zytologie die Entfernung des Implantats und der Kapsel mit anschließenden Verlaufskontrollen.…”

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