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Nestler JA, Kim JK, Goodreau AM, Mountziaris PM, McGuire KP. Invasive stage III breast implant-associated anaplastic large cell lymphoma successfully treated with incomplete resection. BMJ Case Rep 2022; 15:e246664. [PMID: 35379678 PMCID: PMC8981349 DOI: 10.1136/bcr-2021-246664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 11/04/2022] Open
Abstract
A woman with history of bilateral breast augmentation 15 years prior presented with right breast swelling, peri-implant effusion and a palpable inferomedial mass. Effusion aspiration demonstrated pleiomorphic cells consistent with breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Further diagnostic studies confirmed stage III disease with a 4.7 cm right breast mass and fluorodeoxyglucose uptake in an internal mammary chain lymph node. The patient underwent surgery with incomplete resection due to invasion of the chest wall followed by chemotherapy and radiation therapy. BIA-ALCL typically presents as an indolent effusion, however advanced disease carries a worse prognosis. This case highlights successful treatment without recurrence past the one-year mark as well as the need for multidisciplinary management when dealing with advanced disease.
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Affiliation(s)
- John A Nestler
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Jin Kyung Kim
- Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USA
| | - Adam M Goodreau
- Department of Plastic and Reconstructive Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Paschalia M Mountziaris
- Department of Plastic and Reconstructive Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, USA
| | - Kandace P McGuire
- Department of Surgery, Virginia Commonwealth University Health System, Richmond, Virginia, USA
- Massey Cancer Center, Virginia Commonwealth University Health System, Richmond, Virginia, USA
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James ER, Miranda RN, Turner SD. Primary Lymphomas of the Breast: A Review. JPRAS Open 2022; 32:127-143. [PMID: 35402679 PMCID: PMC8987598 DOI: 10.1016/j.jpra.2022.01.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 01/10/2022] [Indexed: 11/06/2022] Open
Abstract
Lymphomas of the breast are rare neoplasms that arise from breast lymphoid tissue and are characterised by neoplastic B or T cells. Breast lymphomas arising from B cells include, but are not limited to, diffuse large B cell lymphoma, follicular lymphoma, extra-nodal marginal zone lymphoma and Burkitt lymphoma. Anaplastic large cell lymphoma (ALCL) is of a T cell origin and both anaplastic lymphoma kinase (ALK)-positive and ALK-negative presentations have been noted in the breast. In addition, there is a more recently identified presentation of ALK-negative ALCL that arises around textured breast implants and is usually confined to a periprosthetic fibrous capsule. Here, we discuss the clinical presentations, histological and immunohistochemical features and treatment options for each type of primary breast lymphoma. We hope that this review will highlight the importance of the timely and accurate diagnosis of breast lymphoma in order to tailor the most appropriate treatment. We also wish to raise awareness of the breast implant-associated lymphomas, with the goal of stimulating work that will aid our understanding of their epidemiology and pathogenesis.
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Corines MJ, Krystel-Whittemore M, Murray M, Mango V. Uncommon Tumors and Uncommon Presentations of Cancer in the Breast. CURRENT BREAST CANCER REPORTS 2021; 13:331-346. [PMID: 36589040 PMCID: PMC9798716 DOI: 10.1007/s12609-021-00435-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Purpose of review The purpose is to present a case series of rare diagnoses and unusual presentations of breast lesions with radiologic-pathologic correlation from a major cancer center, and to review the recent literature on each entity with a focus on radiology-pathology concordance. We present our findings and experience from cases of metastatic small cell lung carcinoma to the breast, IgG-4 related breast disease, breast implant associated anaplastic large cell lymphoma, granular cell tumor, pleomorphic sarcoma, adenomyoepithelioma, post-radiation angiosarcoma, and breast carcinoma after risk-reducing total mastectomy. Recent findings It is essential for physicians to have knowledge of rare breast diagnoses and unusual breast disease presentations to formulate a complete differential diagnosis, recognize radiological-pathological concordance of these entities and provide appropriate patient care. Summary Current literature on these rare described entities exists mainly as case reports, case series and small-scale studies. By sharing our findings, we hope to educate trainees in radiology, pathology and other fields across the continuum of care in radiologic-pathologic correlation, while also augmenting the existing literature on these rare entities.
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Affiliation(s)
- Marina J. Corines
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 300 E 66th Street, New York, NY 10065,Corresponding author: Marina J. Corines, MD, 1275 York Ave, Department of Radiology, New York, New York, 10065, Telephone: (914) 319-6970,
| | | | - Melissa Murray
- Memorial Sloan Kettering Cancer Center, Department of Pathology, 1275 York Avenue, New York, NY 10065
| | - Victoria Mango
- Memorial Sloan Kettering Cancer Center, Department of Radiology, 300 E 66th Street, New York, NY 10065
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Lam M, Migonney V, Falentin-Daudre C. Review of silicone surface modification techniques and coatings for antibacterial/antimicrobial applications to improve breast implant surfaces. Acta Biomater 2021; 121:68-88. [PMID: 33212233 DOI: 10.1016/j.actbio.2020.11.020] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/12/2020] [Accepted: 11/12/2020] [Indexed: 12/19/2022]
Abstract
Silicone implants are widely used in the medical field for plastic or reconstructive surgeries for the purpose of soft tissue issues. However, as with any implanted object, healthcare-associated infections are not completely avoidable. The material suffers from a lack of biocompatibility and is often subject to bacterial/microbial infections characterized by biofilm growth. Numerous strategies have been developed to either prevent, reduce, or fight bacterial adhesion by providing an antibacterial property. The present review summarizes the diverse approaches to deal with bacterial infections on silicone surfaces along with the different methods to activate/oxidize the surface before any surface modifications. It includes antibacterial coatings with antibiotics or nanoparticles, covalent attachment of active bacterial molecules like peptides or polymers. Regarding silicone surfaces, the activation step is essential to render the surface reactive for any further modifications using energy sources (plasma, UV, ozone) or chemicals (acid solutions, sol-gel strategies, chemical vapor deposition). Meanwhile, corresponding work on breast silicone prosthesis is discussed. The latter is currently in the line of sight for causing severe capsular contractures. Specifically, to that end, besides chemical modifications, the antibacterial effect can also be achieved by physical surface modifications by adjusting the surface roughness and topography for instance.
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Verde F, Vigliar E, Romeo V, Campanino MR, Accurso A, Canta L, Garbino N, Basso L, Cavaliere C, Nicolai E, Imbriaco M. Breast implant associated anaplastic large cell lymphoma (BIA-ALCL): a challenging cytological diagnosis with hybrid PET/MRI staging and follow-up. Breast Cancer 2020; 28:527-532. [PMID: 33131026 PMCID: PMC7925497 DOI: 10.1007/s12282-020-01178-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 10/13/2020] [Indexed: 11/30/2022]
Abstract
We report a case of a 55-year-old woman with left breast cosmetic augmentation performed 5 years earlier, showing at ultrasound a left small amount of peri-implant effusion suspicious for an anaplastic large cell lymphoma localization. The final diagnosis was obtained by cytology using a small amount of fluid (6 ml). Subsequently, hybrid 18F-FDG PET/MRI was used for pre-operative staging and follow-up. An appropriate management of BIA-ALCL could be obtained even in cases of a small amount of peri-implant effusion, using a comprehensive approach of clinical and imaging evaluation, including PET/MRI as useful and innovative staging imaging technique.
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Affiliation(s)
- Francesco Verde
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Elena Vigliar
- Department of Public Health, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Valeria Romeo
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy.
| | - Maria Raffaela Campanino
- Department of Public Health, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
| | - Antonello Accurso
- Department of Clinical Medicine and Surgery, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Luigi Canta
- Unit of Plastic and Reconstructive Surgery, AOU Federico II, Via S. Pansini, 5, 80131, Naples, Italy
| | - Nunzia Garbino
- IRCCS SDN, Via Emanuele Gianturco 113, 80143, Naples, Italy
| | - Luca Basso
- IRCCS SDN, Via Emanuele Gianturco 113, 80143, Naples, Italy
| | | | | | - Massimo Imbriaco
- Department of Advanced Biomedical Sciences, University of Naples "Federico II", Via S. Pansini, 5, 80131, Naples, Italy
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Complicaciones infrecuentes de las prótesis de mama. RADIOLOGIA 2020; 62:266-279. [DOI: 10.1016/j.rx.2020.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Revised: 12/10/2019] [Accepted: 01/31/2020] [Indexed: 12/17/2022]
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Sánchez Rubio N, Lannegrand Menéndez B, Duque Muñoz M, Montes Fernández M, Ciudad Fernández M. Uncommon complications of breast prostheses. RADIOLOGIA 2020. [DOI: 10.1016/j.rxeng.2020.01.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Ali N, Sindhu K, Bakst RL. A Rare Case of a Transgender Female With Breast Implant-Associated Anaplastic Large Cell Lymphoma Treated With Radiotherapy and a Review of the Literature. J Investig Med High Impact Case Rep 2020; 7:2324709619842192. [PMID: 31010324 PMCID: PMC6480983 DOI: 10.1177/2324709619842192] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
We are reporting a case of a 54-year-old transgender female with a history of breast augmentation with bilateral silicone implants. Seventeen years later, she presented with an enlarging right breast mass. Pathology confirmed breast implant–associated anaplastic large cell lymphoma (Ann Arbor Stage IIE, TNM Stage III BIA-ALCL). The patient underwent bilateral capsulectomy, sentinel lymph node biopsy with adjuvant CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) chemotherapy, and radiotherapy to the right chest, axilla, and supraclavicular lymph nodes. BIA-ALCL is a rare entity, especially in transgender females. We report this case and a review of the literature in this report.
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Affiliation(s)
- Naba Ali
- 1 University of Rochester, Rochester, NY, USA
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Hobson G, Bates J, Sherbert D. Breast Implant-associated Anaplastic Large Cell Lymphoma Affecting a Neosubpectoral Pocket. Cureus 2020; 12:e7178. [PMID: 32257718 PMCID: PMC7117608 DOI: 10.7759/cureus.7178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The complications associated with breast implants are under perpetual scrutiny to maximize patient safety. In this era of plastic surgery, a new concern being addressed is breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Patients with BIA-ALCL most commonly present several years after implant placement with a periprosthetic fluid collection. The body of literature and reports of BIA-ALCL continues to grow with additional nuances in proposed causes as well as management. Most recently, this has led to a recall of breast implants manufactured utilizing a specific texturing. We describe here the time course, diagnosis, and management of BIA-ALCL in a 52-year-old patient who underwent submuscular implant-based reconstruction and subsequent revision of that reconstruction with the creation of a neosubpectoral pocket. The patient was managed in accordance with current guidelines under the supervision of a multidisciplinary team. In our review of the literature, several case reports, case series, and guideline publications were identified. Current guidelines for management are based on the staging of BIA-ALCL at diagnosis and span from only surgical with implant removal, excision of the lymphoma, and excision of the surrounding fibrous capsule to addition of chemotherapeutic regimens or radiation for distant and locally advanced disease.
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Affiliation(s)
- Greg Hobson
- Plastic Surgery, Beaumont Health, Farmington Hills Campus, Royal Oak, USA
| | - John Bates
- Plastic Surgery, Beaumont Health, Royal Oak, USA
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