Breast implant-associated anaplastic large-cell lymphoma can be a diagnostic challenge for pathologists

Acta Cytol. 2014;58(1):103-7. doi: 10.1159/000355861. Epub 2013 Nov 19.

Abstract

Background: Primary anaplastic large-cell lymphoma (ALCL) occurring in women with breast implants is very rare. It is usually described as tumor cells infiltrating the periprosthetic capsule. These are most often revealed by a periprosthetic recurrent isolated effusion (seroma cavity), occurring late after implantation of the prosthesis. ALCL is more rarely a tumor or periprosthetic capsular contracture.

Case: We report a 66-year-old woman, initially diagnosed by cytological examination of breast effusion, in whom ALCL appeared two and a half months after the removal of a ruptured implant. Repeated biopsies of the periprosthetic capsule performed in parallel showed fibrous tissue, without tumor proliferation. Only meticulous histological examination of the total capsulectomy identified tumor cells as a thin and discontinuous layer along the inner surface of the capsule without capsular invasion.

Conclusion: Awareness of the histological pattern of this new clinical entity is important. A total capsulectomy with a good sampling for microscopic examination should be conducted for any suspicion of breast implant-associated ALCL. Cytology-histology correlation is essential.

Publication types

  • Case Reports

MeSH terms

  • Adenocarcinoma / surgery
  • Aged
  • Breast Implants / adverse effects*
  • Breast Neoplasms / etiology
  • Breast Neoplasms / pathology*
  • Female
  • Humans
  • Lymphoma, Large-Cell, Anaplastic / etiology
  • Lymphoma, Large-Cell, Anaplastic / pathology*
  • Neoplasms, Second Primary / etiology
  • Neoplasms, Second Primary / pathology*
  • Prosthesis Failure