1
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Borde T, Stelter J, Wiedemann A, Böhm C, Ruschke S, Komenda A, Weiss K, Wu M, Makowski MR, Karampinos DC, Fallenberg EM. Silicone implant and fibrous capsule assessment based on water-fat-silicone chemical shift encoding-based species separation in breast MRI. Acta Radiol 2024; 65:716-723. [PMID: 38872362 DOI: 10.1177/02841851241258402] [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] [Indexed: 06/15/2024]
Abstract
BACKGROUND With rising breast augmentations worldwide, there is an increasing clinical need for an early and accurate detection of implant complications. PURPOSE To compare the quality of chemical shift encoding-based (CSE) water-fat-silicone separation compared to double inversion recovery (DIR) silicone-only imaging in breast magnetic resonance imaging (MRI). MATERIAL AND METHODS This retrospective, single-center study included women with silicone implants subjected to 3-T MRI between January 2021 and March 2022. MRI included (i) two-dimensional silicone-only T2-weighted turbo spin echo DIR acquisition and (ii) three-dimensional CSE imaging based on multi-echo gradient-echo sequence enabling water-, fat-, and silicone-image separation. Images were evaluated and compared by three independent radiologists using a clinically established rating including differentiability of the silicone implant, visibility and contouring of the adjacent fibrous capsule, and accuracy of intralesional folds in a ranking of 1-5. The apparent contrast-to-noise (aCNR) was calculated. RESULTS In 71 women, the average quality of water-fat-silicone images from CSE imaging was assessed as "good" (assessment 4 ± 0.9). In 68 (96%) patients, CSE imaging achieved a concise delineation of the silicone implant and precise visualization of the fibrous capsule that was not distinguishable in DIR imaging. Implant ruptures were more easily detected in CSE imaging. The aCNR was higher in CSE compared to DIR imaging (18.43 ± 9.8 vs. 14.73 ± 2.5; P = 0.002). CONCLUSION Intrinsically co-registered water-fat-silicone-separated CSE-based images enable a reliable assessment of silicone implants. The simultaneously improved differentiability of the implant and fibrous capsule may provide clinicians with a valuable tool for an accurate evaluation of implant integrity and early detection of potential complications.
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Affiliation(s)
- Tabea Borde
- Department of Diagnostic and Interventional Radiology, School of Medicine & Health, Technical University of Munich, Munich, Germany
| | - Jonathan Stelter
- Department of Diagnostic and Interventional Radiology, School of Medicine & Health, Technical University of Munich, Munich, Germany
| | - Antonia Wiedemann
- Department of Diagnostic and Interventional Radiology, School of Medicine & Health, Technical University of Munich, Munich, Germany
| | - Christof Böhm
- Department of Diagnostic and Interventional Radiology, School of Medicine & Health, Technical University of Munich, Munich, Germany
| | - Stefan Ruschke
- Department of Diagnostic and Interventional Radiology, School of Medicine & Health, Technical University of Munich, Munich, Germany
| | - Alexander Komenda
- Department of Diagnostic and Interventional Radiology, School of Medicine & Health, Technical University of Munich, Munich, Germany
| | | | - Mingming Wu
- Department of Diagnostic and Interventional Radiology, School of Medicine & Health, Technical University of Munich, Munich, Germany
| | - Marcus R Makowski
- Department of Diagnostic and Interventional Radiology, School of Medicine & Health, Technical University of Munich, Munich, Germany
| | - Dimitrios C Karampinos
- Department of Diagnostic and Interventional Radiology, School of Medicine & Health, Technical University of Munich, Munich, Germany
| | - Eva M Fallenberg
- Department of Diagnostic and Interventional Radiology, School of Medicine & Health, Technical University of Munich, Munich, Germany
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2
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Vittorietti M, Mazzola S, Costantino C, De Bella DD, Fruscione S, Bonaccorso N, Sciortino M, Costanza D, Belluzzo M, Savatteri A, Tramuto F, Contiero P, Tagliabue G, Immordino P, Vitale F, Di Napoli A, Mazzucco W. Implant replacement and anaplastic large cell lymphoma associated with breast implants: a quantitative analysis. Front Oncol 2023; 13:1202733. [PMID: 37927474 PMCID: PMC10622658 DOI: 10.3389/fonc.2023.1202733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 09/28/2023] [Indexed: 11/07/2023] Open
Abstract
Introduction Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare form of non-Hodgkin T-cell lymphoma associated with breast reconstruction post-mastectomy or cosmetic-additive mammoplasty. The increasing use of implants for cosmetic purposes is expected to lead to an increase in BIA-ALCL cases. This study investigated the main characteristics of the disease and the factors predicting BIA-ALCL onset in patients with and without an implant replacement. Methods A quantitative analysis was performed by two independent researchers on cases extracted from 52 primary studies (case report, case series, and systematic review) published until April 2022 and searched in PubMed, Scopus, and Google-Scholar databases using "Breast-Implant" AND/OR "Associated" AND/OR "Anaplastic-Large-Cell-Lymphoma". The statistical significance was verified by Student's t-test for continuous variables, while Fisher's exact test was applied for qualitative variables. Cox model with time-dependent covariates was used to estimate BIA-ALCL's onset time. The Kaplan-Meier model allowed the estimation of the probability of survival after therapy according to breast implant exposure time. Results Overall, 232 patients with BIA-ALCL were extracted. The mean age at diagnosis was 55 years old, with a mean time to disease onset from the first implant of 10.3 years. The hazard of developing BIA-ALCL in a shorter time resulted significantly higher for patients not having an implant replacement (hazard ratio = 0.03; 95%CI: 0.005-0.19; p-value < 0.01). Patients with implant replacement were significantly older than patients without previous replacement at diagnosis, having a median time to diagnosis since the first implant of 13 years (7 years in patients without replacement); anyway, the median time to BIA-ALCL occurrence since the last implantation was equal to 5 years. Discussion Our findings suggest that, in BIA-ALCL patients, the implant substitution and/or capsulectomy may delay the disease's onset. However, the risk of reoccurrence in an earlier time should be considered in these patients. Moreover, the time to BIA-ALCL onset slightly increased with age. Selection bias, lack of awareness, misdiagnosis, and limited data availability could be identified as limits of our study. An implant replacement should be considered according to a risk stratification approach to delay the BIA-ALCL occurrence in asymptomatic patients, although a stricter follow-up after the implant substitution should be recommended. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO, identifier: CRD42023446726.
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Affiliation(s)
| | - Sergio Mazzola
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, Palermo, Italy
| | - Claudio Costantino
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, Palermo, Italy
- PROMISE Department, University of Palermo, Palermo, Italy
| | | | | | | | | | | | | | | | - Fabio Tramuto
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, Palermo, Italy
- PROMISE Department, University of Palermo, Palermo, Italy
| | - Paolo Contiero
- Environmental Epidemiology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Giovanna Tagliabue
- Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Francesco Vitale
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, Palermo, Italy
- PROMISE Department, University of Palermo, Palermo, Italy
| | - Arianna Di Napoli
- Department of Clinical and Molecular Medicine, University of Rome “Sapienza”, Rome, Italy
| | - Walter Mazzucco
- U.O.C. of Clinical Epidemiology with Cancer Registry, Azienda Ospedaliera Universitaria Policlinico di Palermo, Palermo, Italy
- PROMISE Department, University of Palermo, Palermo, Italy
- College of Medicine, University of Cincinnati, Cincinnati, OH, United States
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3
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Breast Implant Illness: Surgical, Autoimmune, and Breast Reconstruction Associations. SURGERIES 2022. [DOI: 10.3390/surgeries3020013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Breast implant illness refers to a combination of different symptoms related to breast implant surgery, including fatigue, brain fog, and arthralgias. This malaise occurs after cosmetic and reconstructive breast surgeries, although it has not been proven to be a disease. Even recent studies have reported concluding statements of the etiology, diagnosis, and treatment as unclear and widely unknown. Therefore, this review aimed to determine the associations between the manifestations of breast implant illness in surgery and breast reconstruction, as well as the autoimmune responses involved. Complications associated with breast implants include breast pain, capsular contracture, infections, as well as other manifestations specific to breast reconstruction. Moreover, patients with implants may present with new-onset systemic sclerosis, Sjögren’s syndrome, and connective tissue diseases. However, the incidence of capsular contracture has steadily decreased with each generation of implants, particularly since the development of textured implants, as well as with the use of antibiotics and antiseptic pocket irrigation. However, the incidence of anaplastic large cell lymphoma has increased with the use of textured implants. Remarkably, the autoimmune response to these implants remains unclear. Therefore, close follow-up, careful observation of any symptom presentation, and evidence-based treatment decisions are necessary for patients with breast implants.
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4
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Kang D, Yoon SE, Shin D, Lee J, Hong YS, Lee SK, Lee JE, Park YH, Ahn JS, Guallar E, Kim WS, Lee J, Kim SJ, Cho J. Risk of non-Hodgkin lymphoma in breast cancer survivors: a nationwide cohort study. Blood Cancer J 2021; 11:200. [PMID: 34907177 PMCID: PMC8671407 DOI: 10.1038/s41408-021-00595-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Several studies have suggested that estrogens have a protective function against lymphomagenesis. The treatment of breast cancer is driven by subtype classification, and the assessment of hormone receptor status is important for treatment selection. Thus, we evaluated the association between breast cancer and the incidence of NHL. We conducted a retrospective cohort study using a population-based nationwide registry in South Korea. We selected all women with newly diagnosed breast cancer between January 1st, 2002 and December 31st, 2016 who received curative treatment (N = 84,969) and a 1:10 sample of age-matched non-breast cancer controls (N = 1,057,674). Incident breast cancer (time-varying exposure) was the exposure and development of any type of NHL, including diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), mature T/NK-cell lymphomas, anaplastic large cell lymphoma (ALCL), and unspecified types of NHL, was the outcome. During follow-up, 1564 incident cases of NHL occurred. The fully adjusted Hazard Ratio (HR) for NHL associated with the development of breast cancer was 1.64 (95% CI = 1.34–2.00) after adjusting for body mass index, alcohol intake, physical activity, smoking, income, and comorbidity. The adjusted HR for NHL was much higher in participants who were aged <50 years and who received hormone therapy (either tamoxifen or aromatase inhibitors) than in those ≥50 years or who did not receive hormone therapy, respectively. The development of breast cancer was associated with a significantly increased risk of NHL, particularly follicular lymphoma and mature T/NK-cell lymphoma. In particular, the risk of NHL was higher in patients receiving hormone therapy and in younger patients.
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Affiliation(s)
- Danbee Kang
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Sang Eun Yoon
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Dongwook Shin
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.,Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin Lee
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea.,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea
| | - Yun Soo Hong
- Department of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Se Kyung Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Eon Lee
- Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yeon Hee Park
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jin Seok Ahn
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Eliseo Guallar
- Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea.,Department of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Won Seog Kim
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea
| | - Jungho Lee
- Department of Plastic Surgery, The Catholic University of Korea, Bucheon ST. Mary's Hospital, Bucheon, South Korea
| | - Seok Jin Kim
- Division of Hematology/Oncology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. .,Department of Health Sciences and Technology, SAIHST, Sungkyunkwan University, Seoul, Korea.
| | - Juhee Cho
- Department of Clinical Research Design and Evaluation, SAIHST, Sungkyunkwan University, Seoul, Korea. .,Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea. .,Department of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.
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5
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Thandra KC, Barsouk A, Saginala K, Padala SA, Barsouk A, Rawla P. Epidemiology of Non-Hodgkin's Lymphoma. Med Sci (Basel) 2021; 9:medsci9010005. [PMID: 33573146 PMCID: PMC7930980 DOI: 10.3390/medsci9010005] [Citation(s) in RCA: 101] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/26/2021] [Accepted: 01/27/2021] [Indexed: 12/24/2022] Open
Abstract
Non-Hodgins’s lymphoma (NHL) is the most common hematological malignancy worldwide, accounting for nearly 3% of cancer diagnoses and deaths. NHL is the seventh most prevalent cancer and has the sixth highest mortality among cancers in the US. NHL accounts for 4% of US cancer diagnoses, and incidence has increased 168% since 1975 (while survival has improved 158%). NHL is more common among men, those >65 years old, and those with autoimmune disease or a family history of hematological malignancies. NHL is a heterogenous disease, with each subtype associated with different risk factors. Marginal zone lymphoma (MZL) is strongly associated with Sjogren’s syndrome (SS) and Hashimoto’s thyroiditis, while peripheral T-cell lymphoma (PTCL) is most associated with celiac disease. Occupational exposures among farm workers or painters increases the risk of most of the common subtypes. Prior radiation treatment, obesity, and smoking are most highly associated with diffuse large B-cell lymphoma (DLBCL), while breast implants have been rarely associated with anaplastic large cell lymphoma (ALCL). Infection with Epstein–Barr Virus (EBV) is strongly associated with endemic Burkitts lymphoma. HIV and human herpes virus 8 (HHV-8), is predisposed to several subtypes of DLBCL, and human T-cell lymphoma virus (HTLV-1) is a causative agent of T-cell lymphomas. Obesity and vitamin D deficiency worsen NHL survival. Atopic diseases and alcohol consumption seem to be protective against NHL.
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Affiliation(s)
- Krishna C. Thandra
- Department of Pulmonary and Critical Care Medicine, Sentara Virginia Beach General Hospital, Virginia Beach, VA 23455, USA
- Correspondence: ; Tel.: +1-757-481-2515
| | - Adam Barsouk
- Sidney Kimmel Cancer Center, Jefferson University, Philadelphia, PA 19107, USA;
| | - Kalyan Saginala
- Plains Regional Medical Group Internal Medicine, Clovis, NM 88101, USA;
| | - Sandeep Anand Padala
- Department of Medicine, Nephrology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA;
| | - Alexander Barsouk
- Hematologist-Oncologist, Allegheny Health Network, Pittsburgh, PA 15212, USA;
| | - Prashanth Rawla
- Department of Medicine, Sovah Health, Martinsville, VA 24112, USA;
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6
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Lee JH. Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL). Yeungnam Univ J Med 2021; 38:175-182. [PMID: 33461261 PMCID: PMC8225493 DOI: 10.12701/yujm.2020.00801] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 12/01/2020] [Indexed: 11/06/2022] Open
Abstract
Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare T-cell non-Hodgkin lymphoma characterized as CD30 positive and anaplastic lymphoma kinase (ALK) negative. In 2016, the World Health Organization declared BIA-ALCL as a new disease entity. The first case of BIA-ALCL was reported in 1997, and as of July 2019, the United States Food and Drug Administration had cited a total of 573 United States and global medical device reports of BIA-ALCL, including 33 deaths. In all clinical case reports, except for those with unknown clinical history, the patient had received at least one textured surface breast implant. Although the etiology is not yet clear, chronic inflammation has been proposed as a potential precursor to tumorigenesis. The most common presentation of BIA-ALCL is peri-implant fluid collection following aesthetic or reconstructive implantation with textured surface breast implants. It can be accompanied by breast swelling, asymmetry, pain, skin lesions, lymphadenopathy, and B-type symptoms. Most cases are detected on average 7 to 10 years after implantation. Diagnostic specimens can be obtained with fine-needle aspiration or biopsy. BIA-ALCL is CD30 positive, epithelial membrane antigen positive, and ALK negative. It can be cured with complete surgical excision at the T1–T3 stage.
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Affiliation(s)
- Jun-Ho Lee
- Department of Plastic and Reconstructive Surgery, Yeungnam University College of Medicine, Daegu, Korea
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7
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Johnson L, Lowry K, Scheel J, Mau B, Rockoff SJ. Breast implant-associated anaplastic large cell lymphoma with contralateral invasive lobular carcinoma. Radiol Case Rep 2020; 15:2572-2576. [PMID: 33082901 PMCID: PMC7552810 DOI: 10.1016/j.radcr.2020.09.033] [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: 09/01/2020] [Revised: 09/08/2020] [Accepted: 09/09/2020] [Indexed: 11/17/2022] Open
Abstract
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of T-cell lymphoma that arises in the setting of textured breast implants. In this case report, a 69-year-old woman with a remote history of right-sided invasive lobular carcinoma status post right mastectomy and bilateral breast reconstruction presents with spontaneous right breast swelling and pain, suspicious for implant rupture. Diagnostic MRI revealed a peri-implant fluid collection in the right breast and focal nonmass enhancement in the left breast. The patient was ultimately diagnosed with right-sided BIA-ALCL and left-sided invasive lobular carcinoma. Although intravenous gadolinium contrast is not needed to assess implant integrity, it can be used to evaluate for malignancy when the patient is at an increased risk for developing breast cancer. In this case, the use of contrast revealed the rare instance of a synchronous contralateral invasive lobular carcinoma. Despite the rarity of BIA-ALCL with an estimated incidence of 1:30,000 in women with textured implants, it is essential that radiologists include this entity in the differential in the appropriate clinical setting as surgical resection is curative if performed before the disease has spread.
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Affiliation(s)
- Lisa Johnson
- University of Washington, Department of Radiology, 1959 N.E. Pacific St., Box 357115, Seattle, WA 98195-7115
- Corresponding author.
| | - Kathryn Lowry
- Breast Imaging Section, Department of Radiology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA
| | - John Scheel
- Breast Imaging Section, Department of Radiology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA
| | - Brian Mau
- University of Washington, Department of Laboratory Medicine and Pathology, 1959 Seattle, WA
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8
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Liu B, Liu H, Guo L, Ma Y, Guan M, Liu M. Primary Pulmonary Diffuse Large B Cell Lymphoma Mimicking Metastasis: A Case Report and Literature Review. Onco Targets Ther 2020; 13:5837-5843. [PMID: 32606794 PMCID: PMC7311097 DOI: 10.2147/ott.s251344] [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: 02/26/2020] [Accepted: 05/22/2020] [Indexed: 11/23/2022] Open
Abstract
Primary pulmonary diffuse large B cell lymphoma (PPDLBCL) is extremely rare, with fewer than 40 cases reported to date and a lack of systemic analysis. Herein, we present a case of PPDLBCL mimicking metastasis in a heavily treated patient with breast cancer. To our knowledge, this is the first reported case of PPDLBCL in a patient with breast cancer. A 66-year-old Chinese female diagnosed with breast cancer 7.5 years previously and multiple bone metastases 31 months later presented with a new-onset subpleural nodule in the inferior lobe of left lung detected by routine follow-up in November 2017. A 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography scan showed that the pulmonary nodule was hypermetabolic with a maximum standard uptake value of 14.9, consistent with lung metastasis in view of her history of breast cancer and multiple bone involvement. Surprisingly, pathologic investigation revealed primary lung DLBCL, staged IEA. Systemic chemotherapy with R-CDOP (rituximab, cyclophosphamide, vindesine, doxorubicin liposome, and prednisone) achieved complete remission with mild side effects. At the latest follow-up in August 2019, the patient had disease-free survival of 21 months. The findings from this case indicate that primary pulmonary lymphoma should be included in the differential diagnostic checklist of pulmonary occupancy, even in solid tumor patients treated with multiple modalities. When a newly developed lung nodule is identified in such patients, clinicians should not take for granted that it is lung metastasis. Pathology results are a prerequisite for making a correct diagnosis, choosing appropriate treatment, and improving patient prognosis.
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Affiliation(s)
- Bailong Liu
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Hui Liu
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Liang Guo
- Department of Pathology, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Yunfei Ma
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Meng Guan
- Cancer Center, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
| | - Min Liu
- Department of Radiation Oncology, The First Hospital of Jilin University, Changchun, Jilin, People's Republic of China
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9
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Prantl L, Gerken M, Zeman F, Leitzmann M, Koller M, Klinkhammer-Schalke M, Evert M, Kuehlmann B, Biermann N. Incidence of Anaplastic Large Cell Lymphoma and Breast-Implant-Associated Lymphoma-An Analysis of a Certified Tumor Registry over 17 Years. J Clin Med 2020; 9:jcm9051247. [PMID: 32344893 PMCID: PMC7288050 DOI: 10.3390/jcm9051247] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 04/14/2020] [Accepted: 04/21/2020] [Indexed: 12/25/2022] Open
Abstract
Background: Breast-implant-associated anaplastic large cell lymphoma (BI-ALCL) and primary breast ALCL are rare extranodal manifestations of non-Hodgkin lymphoma. The rarity of both diseases, along with unreleased sales data on breast implants and constant updates of classification systems impede the calculation of an exact incidence. Methods: The database of the Tumor Center Regensburg in Bavaria was searched for patients with CD30-positive and ALK-negative anaplastic large cell lymphoma between 2002 and 2018. These lymphomas were identified by the ICD-O-3 morphology code “97023” and were cross-checked by searching the diagnosis by name the and ICD-10 code C84.7. Furthermore, we tried to calculate the incidence rates and corresponding 95% confidence intervals, standardized to 1,000,000 implant years of breast-implant-associated anaplastic large cell lymphoma and primary breast anaplastic large cell lymphoma. Results: Twelve ALK-negative and CD30-positive anaplastic large cell lymphomas were identified out of 170,405 malignancies. No case was found within the breast tissue and none of the patients had a previous history of breast implant placement. In five cases, lymph node involvement in close proximity to the breast was observed. Conclusion: We found a low incidence of anaplastic large cell lymphoma and no association to breast implants in these patients. A review of the current literature revealed inconsistent use of classification systems for anaplastic large cell lymphomas and potential overestimation of cases.
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Affiliation(s)
- Lukas Prantl
- University Center of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (B.K.); (N.B.)
- Correspondence: ; Tel.: +49-941-944-6763
| | - Michael Gerken
- Tumor Center Regensburg, Institute for Quality Assurance and Health Services Research, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (M.G.); (M.K.-S.)
| | - Florian Zeman
- Center for Clinical Studies, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (F.Z.); (M.K.)
| | - Michael Leitzmann
- Department of Epidemiology and Preventive Medicine, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany;
| | - Michael Koller
- Center for Clinical Studies, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (F.Z.); (M.K.)
| | - Monika Klinkhammer-Schalke
- Tumor Center Regensburg, Institute for Quality Assurance and Health Services Research, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (M.G.); (M.K.-S.)
| | - Matthias Evert
- Department of Pathology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany;
| | - Britta Kuehlmann
- University Center of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (B.K.); (N.B.)
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, 770 Welch Road, Palo Alto, CA 94304, USA
| | - Niklas Biermann
- University Center of Plastic, Hand- and Reconstructive Surgery, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany; (B.K.); (N.B.)
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10
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Kim JH, Paik NS, Nam SY, Cho Y, Park HK. The Emerging Crisis of Stakeholders in Implant-based Augmentation Mammaplasty in Korea. J Korean Med Sci 2020; 35:e103. [PMID: 32301294 PMCID: PMC7167397 DOI: 10.3346/jkms.2020.35.e103] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 02/10/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Korea is no longer safe from the risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL); the first reported case was a Korean woman in her 40s who had a 7-year-history of receiving an implant-based augmentation mammaplasty using a textured implant. We conducted this study to discuss the emerging crisis of stakeholders in implant-based augmentation mammaplasty and to propose a multi-disciplinary approach to early detection of its complications. METHODS We analyzed medical examination data that was collected from patients who visited us between August 12 and September 27, 2019. We evaluated a total of 114 women (n = 114) in the current study. They were evaluated for whether they were in healthy condition. Moreover, their baseline characteristics were also examined; these included age, gender, height (cm), weight (kg), duration since surgery (years), possession of a breast implant card, the site of surgical incision, side of symptoms and reasons for outpatient visit. Furthermore, the patients were also evaluated for their subjective awareness of the manufacturer, surface and shape of the breast implant. Potential complications include malrotation, folding, seroma, capsule thickening, upside-down rotation, rupture, capsule mass and breast mass. RESULTS A majority of the patients had a past history of receiving textured implants. The corresponding percentage was 78.95% (90/114) and 85.09% (97/114) based on their subjective awareness of a breast implant and sonographic findings, respectively. That is, it was slightly increased with the use of a breast ultrasound. CONCLUSION Here, we propose the following approaches. First, patient data should be prospectively collected. By tracking outcomes and complications of an implant-based augmentation mammaplasty, both high-quality care and patient safety can be ensured. Second, stakeholders in implant-based augmentation mammaplasty should collaborate with customers and regulatory authorities. Third, surgeons should consider applying imaging modalities for early detection of postoperative complications.
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Affiliation(s)
| | - Nam Sun Paik
- Department of Surgery, Breast and Thyroid Cancer Center, Ewha Womans University School of Medicine, Seoul, Korea
| | - Sang Yu Nam
- Department of Radiology, Gachon University Gil Medical Center, Incheon, Korea
| | - Younghye Cho
- Department of Pathology, Jangwon Medical Foundation, Seoul, Korea
| | - Heung Kyu Park
- Department of Surgery, Breast Cancer Center, Gachon University Gil Medical Center, Incheon, Korea.
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Ditsch N, Untch M, Thill M, Müller V, Janni W, Albert US, Bauerfeind I, Blohmer J, Budach W, Dall P, Diel I, Fasching PA, Fehm T, Friedrich M, Gerber B, Hanf V, Harbeck N, Huober J, Jackisch C, Kolberg-Liedtke C, Kreipe HH, Krug D, Kühn T, Kümmel S, Loibl S, Lüftner D, Lux MP, Maass N, Möbus V, Müller-Schimpfle M, Mundhenke C, Nitz U, Rhiem K, Rody A, Schmidt M, Schneeweiss A, Schütz F, Sinn HP, Solbach C, Solomayer EF, Stickeler E, Thomssen C, Wenz F, Witzel I, Wöckel A. AGO Recommendations for the Diagnosis and Treatment of Patients with Early Breast Cancer: Update 2019. Breast Care (Basel) 2019; 14:224-245. [PMID: 31558897 PMCID: PMC6751475 DOI: 10.1159/000501000] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Accepted: 05/16/2019] [Indexed: 12/11/2022] Open
Affiliation(s)
- Nina Ditsch
- Brustzentrum, Klinik für Gynäkologie und Geburtshilfe, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany
| | - Michael Untch
- Klinik für Gynäkologie und Geburtshilfe, Helios Klinikum Berlin-Buch, Berlin, Germany
| | - Marc Thill
- Klinik für Gynäkologie und Gynäkologische Onkologie, Agaplesion Markus Krankenhaus, Frankfurt am Main, Germany
| | - Volkmar Müller
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Wolfgang Janni
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Ulm, Ulm, Germany
| | - Ute-Susann Albert
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kassel, Kassel, Germany
| | | | - Jens Blohmer
- Klinik für Gynäkologie mit Brustzentrum der Charité, Berlin, Germany
| | - Wilfried Budach
- Strahlentherapie, Radiologie Düsseldorf, Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Peter Dall
- Frauenklinik Städtisches Klinikum Lüneburg, Lüneburg, Germany
| | - Ingo Diel
- Praxisklinik am Rosengarten, Mannheim, Germany
| | | | - Tanja Fehm
- Klinik für Gynäkologie und Geburtshilfe Universitätsklinikum Düsseldorf, Düsseldorf, Germany
| | - Michael Friedrich
- Klinik für Frauenheilkunde und Geburtshilfe Helios Klinikum Krefeld, Krefeld, Germany
| | - Bernd Gerber
- Universitätsfrauenklinik am Klinikum Südstadt, Rostock, Germany
| | - Volker Hanf
- Frauenklinik Nathanstift, Klinikum Fürth, Fürth, Germany
| | - Nadia Harbeck
- Brustzentrum, Klinik für Gynäkologie und Geburtshilfe, Klinikum der Ludwig-Maximilians-Universität, Munich, Germany
| | - Jens Huober
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Ulm, Ulm, Germany
| | - Christian Jackisch
- Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Offenbach, Offenbach, Germany
| | | | | | - David Krug
- Klinik für Strahlentherapie, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Thorsten Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen, Esslingen, Germany
| | - Sherko Kümmel
- Klinik für Senologie, Kliniken Essen Mitte, Essen, Germany
| | - Sibylle Loibl
- German Breast Group Forschungs GmbH, Neu-Isenburg, Germany
| | - Diana Lüftner
- Medizinische Klinik mit Schwerpunkt Hämatologie und Onkologie, Charité, Berlin, Germany
| | - Michael Patrick Lux
- Klinik für Gynäkologie und Geburtshilfe, St. Vinzenz-Krankenhaus GmbH Paderborn, Paderborn, Germany
| | - Nicolai Maass
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Volker Möbus
- Klinik für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst GmbH, Frankfurt am Main, Germany
| | - Markus Müller-Schimpfle
- Klinik für Radiologie, Neuroradiologie und Nuklearmedizin, Klinikum Frankfurt Höchst GmbH, Frankfurt am Main, Germany
| | - Christoph Mundhenke
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Ulrike Nitz
- Senologie, Evangelisches Krankenhaus Bethesda, Mönchengladbach, Germany
| | - Kerstin Rhiem
- Zentrum Familiärer Brust- und Eierstockkrebs, Universitätsklinikum Köln, Köln, Germany
| | - Achim Rody
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
| | - Marcus Schmidt
- Klinik und Poliklinik für Geburtshilfe und Frauengesundheit der Johannes-Gutenberg-Universität Mainz, Mainz, Germany
| | - Andreas Schneeweiss
- Gynäkologische Onkologie, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Florian Schütz
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Hans-Peter Sinn
- Sektion Gynäkopathologie, Pathologisches Institut, Heidelberg, Germany
| | - Christine Solbach
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany
| | - Erich-Franz Solomayer
- Klinik für Frauenheilkunde, Geburtshilfe und Reproduktionsmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany
| | - Elmar Stickeler
- Klinik für Gynäkologie und Geburtsmedizin, Universitätsklinikum Aachen, Aachen, Germany
| | - Christoph Thomssen
- Universitätsfrauenklinik, Martin-Luther-Universität Halle-Wittenberg, Halle/Saale, Germany
| | | | - Isabell Witzel
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Achim Wöckel
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Würzburg, Würzburg, Germany
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Fricke A, Wagner JA, Kricheldorff J, Rancsó C, Von Fritschen U. Microbial detection in seroma fluid preceding the diagnosis of breast implant-associated anaplastic large cell lymphoma: a case report and review of the literature. Case Reports Plast Surg Hand Surg 2019; 6:116-120. [PMID: 32002457 PMCID: PMC6968569 DOI: 10.1080/23320885.2019.1593846] [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] [Received: 10/24/2018] [Accepted: 03/07/2019] [Indexed: 11/22/2022]
Abstract
The Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) represents a topic of great concern. We report the case of a patient with late-onset seroma, who was initially diagnosed with an implant-related infection of the breast due to microbial detection in the seroma fluid, thus delaying the diagnosis of BIA-ALCL.
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Affiliation(s)
- A. Fricke
- Department of Plastic and Aesthetic Surgery, Hand Surgery, HELIOS Hospital Emil von Behring, Berlin, Germany
| | - J. A. Wagner
- Department of Plastic and Aesthetic Surgery, Hand Surgery, HELIOS Hospital Emil von Behring, Berlin, Germany
| | - J. Kricheldorff
- Department of Plastic and Aesthetic Surgery, HELIOS Hospital Berlin-Buch, Germany
| | - C. Rancsó
- Department of Pathology, HELIOS Hospital Emil von Behring, Berlin, Germany
| | - U. Von Fritschen
- Department of Plastic and Aesthetic Surgery, Hand Surgery, HELIOS Hospital Emil von Behring, Berlin, Germany
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