TY - JOUR
T1 - Anaplastic large cell lymphoma associated with breast implants
T2 - A report of 13 cases
AU - Aladily, Tariq N.
AU - Medeiros, L. Jeffrey
AU - Amin, Mitual B.
AU - Haideri, Nisreen
AU - Ye, Dongjiu
AU - Azevedo, Sergio J.
AU - Jorgensen, Jeffrey L.
AU - De Peralta-Venturina, Mariza
AU - Mustafa, Eid B.
AU - Young, Ken H.
AU - You, M. James
AU - Fayad, Luis E.
AU - Blenc, Ann Marie
AU - Miranda, Roberto N.
PY - 2012/7
Y1 - 2012/7
N2 - We report 13 cases of anaplastic large cell lymphoma (ALCL) associated with breast implants. Patient age ranged from 39 to 68 years, and the interval from implant to ALCL was 4 to 29 years. All tumors were composed of large, pleomorphic cells that were CD30 + and ALK1, and all 7 cases assessed had monoclonal T-cell receptor γ-chain rearrangements. Two patient subgroups were identified. Ten patients presented with effusion surrounded by fibrous capsule without a grossly identifiable tumor mass. Nine patients had stage I and 1 had stage II disease. Eight patients underwent implant removal and capsulectomy. Four patients received chemotherapy and 4 radiation therapy. All patients were alive without disease at last follow-up. A second subgroup of 3 patients had effusion and a distinct mass adjacent to the implant. One patient had stage I and 2 stage II disease. One patient had a 3-year history of lymphomatoid papulosis, and 1 patient had a 1-year history of CD30 + T-cell lymphoma adjacent to the breast before the diagnosis of ALCL associated with breast implant. Two patients received chemotherapy and 1 radiation therapy. Two patients died 2 and 12 years after diagnosis, respectively. We conclude that the clinical behavior of ALCL associated with breast implants is heterogeneous. Patients who present with effusion without a distinct mass have an indolent disease course, similar to CD30 + lymphoproliferative disorder of skin. In contrast, patients who present with a distinct mass may have advanced stage or possibly systemic disease and have a poorer prognosis.
AB - We report 13 cases of anaplastic large cell lymphoma (ALCL) associated with breast implants. Patient age ranged from 39 to 68 years, and the interval from implant to ALCL was 4 to 29 years. All tumors were composed of large, pleomorphic cells that were CD30 + and ALK1, and all 7 cases assessed had monoclonal T-cell receptor γ-chain rearrangements. Two patient subgroups were identified. Ten patients presented with effusion surrounded by fibrous capsule without a grossly identifiable tumor mass. Nine patients had stage I and 1 had stage II disease. Eight patients underwent implant removal and capsulectomy. Four patients received chemotherapy and 4 radiation therapy. All patients were alive without disease at last follow-up. A second subgroup of 3 patients had effusion and a distinct mass adjacent to the implant. One patient had stage I and 2 stage II disease. One patient had a 3-year history of lymphomatoid papulosis, and 1 patient had a 1-year history of CD30 + T-cell lymphoma adjacent to the breast before the diagnosis of ALCL associated with breast implant. Two patients received chemotherapy and 1 radiation therapy. Two patients died 2 and 12 years after diagnosis, respectively. We conclude that the clinical behavior of ALCL associated with breast implants is heterogeneous. Patients who present with effusion without a distinct mass have an indolent disease course, similar to CD30 + lymphoproliferative disorder of skin. In contrast, patients who present with a distinct mass may have advanced stage or possibly systemic disease and have a poorer prognosis.
KW - anaplastic large cell lymphoma
KW - breast implant-associated ALCL
KW - non-Hodgkin lymphoma
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U2 - 10.1097/PAS.0b013e31825749b1
DO - 10.1097/PAS.0b013e31825749b1
M3 - Article
C2 - 22613996
AN - SCOPUS:84863316196
SN - 0147-5185
VL - 36
SP - 1000
EP - 1008
JO - American Journal of Surgical Pathology
JF - American Journal of Surgical Pathology
IS - 7
ER -