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- Title
Anaplastic large cell lymphoma associated with breast implant capsule.
- Authors
Shah, Sejal S.; Chandan, Vishal S.
- Abstract
Objective: Primary breast lymphomas are uncommon and predominantly of B-cell phenotype. We present a rare case of primary anaplastic large cell lymphoma of the breast in association with a silicone breast implant capsule. Method: A 66-year old woman underwent bilateral silicone breast implants 30 years ago with replacement in 2001. She recently presented with swelling and breast asymmetry. A seroma was noticed adjacent to the implant. Fluid was aspirated which showed atypical cells. She underwent removal of the right breast implant and capsule. Data and Results: The sections of the capsule showed a fibrous wall containing large pleomorphic cells with prominent nucleoli and abundant pale cytoplasm. Immunostains demonstrated that the neoplastic cells were positive for CD30, CD43, and CD4, with aberrant loss of other T-cell markers, including CD2, and CD5. The CD3 stain was weakly positive in a small subset of neoplastic cells and clusterin was also very focally positive. No B-cell or plasma cell markers such as CD20, PAX-5 or CD138 were expressed. The tumour cells were negative for ALK- 1, keratins, melanoma markers and CD34. In the absence of systemic disease per additional work-up, the findings support the diagnosis of seroma-associated primary anaplastic large-cell lymphoma. Conclusions: Seroma-associated primary anaplastic large cell lymphoma is a distinct clinicopathological entity that arises in association with the effusion around a breast implant. The tumour is characterized by histologically malignant T-cells showing uniform CD30 expression, ALK negativity, and indolent clinical behavior. The treatment of choice is surgical removal of the capsule and implant.
- Subjects
BREAST implants; B cells; CYTOPLASM; MELANOMA; T cells
- Publication
Canadian Journal of Pathology, 2017, Vol 9, p17
- ISSN
1918-915X
- Publication type
Article