Breast implant-associated anaplastic large cell lymphoma: a review

Breast implant-associated anaplastic large cell lymphoma is a newly recognized provisional entity in the 2017 revision of the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues. It is an uncommon, slow growing T-cell lymphoma with morphology and immunophenotype...

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Bibliographic Details
Published in:Modern pathology 2019-02, Vol.32 (2), p.166-188
Main Authors: Quesada, Andrés E, Medeiros, L Jeffrey, Clemens, Mark W, Ferrufino-Schmidt, Maria C, Pina-Oviedo, Sergio, Miranda, Roberto N
Format: Article
Language:English
Subjects:
Anaplastic large-cell lymphoma
Breast
Breast cancer
Breast implants
Breast Implants - adverse effects
Chemotherapy
Cytology
Effusion
Epidemiology
Female
Humans
Interferon
Lymph nodes
Lymphocytes T
Lymphoid tissue
Lymphoma
Lymphoma, Large-Cell, Anaplastic - etiology
Parenchyma
Protein-tyrosine kinase
T-cell lymphoma
Transplants & implants
Tumors
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Summary:Breast implant-associated anaplastic large cell lymphoma is a newly recognized provisional entity in the 2017 revision of the World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues. It is an uncommon, slow growing T-cell lymphoma with morphology and immunophenotype similar to anaplastic lymphoma kinase-negative anaplastic large cell lymphoma. However, the presentation and treatment are unique. Breast implant-associated anaplastic large cell lymphoma often presents as a unilateral effusion confined to the capsule of a textured-surface breast implant, a median time of 9 years after the initial implants have been placed. Although it follows an indolent clinical course, breast implant-associated anaplastic large cell lymphoma has the potential to form a mass, to invade locally through the capsule into breast parenchyma or soft tissue and/or to spread to regional lymph nodes. In most cases, an explantation with a complete capsulectomy removing all disease, without chemotherapy is considered to be curative and confers an excellent event free and overall survival. Here we provide a comprehensive review of breast implant-associated anaplastic large cell lymphoma, including history, epidemiology, clinical features, imaging and pathology findings, pathologic handling, pathogenic mechanisms, model for progression, therapy and outcomes as well as an analysis of causality between breast implants and anaplastic large cell lymphoma.
ISSN:0893-3952
1530-0285
DOI:10.1038/s41379-018-0134-3