The management of breast implant-associated anaplastic large cell lymphoma in the setting of pregnancy: seeking for clinical practice guidelines

Breast Implant-Associated Anaplastic Large Cell Lymphoma Presenting in a Postpartum Patient: A Case Report

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare cancer found in women with breast implants, occurring approximately eight years after their placement. Since the initial case report of BIA-ALCL in 1997, over 700 cases have been described worldwide and there is now a registry of cases diagnosed in the United States to help learn more about this disease process and prognosis. The majority of cases have been associated with Allergan's textured implants which have been recalled. As this disease is relatively rare with only 1,130 cases described worldwide, it is important to keep BIA-ALCL in mind in the differential diagnosis of a woman presenting with breast swelling and peri-implant fluid collection in the setting of having a textured implant. Outcomes for women with BIA-ALCL are favorable, as most disease is contained within the peri-implant capsule. Thus, complete surgical resection is often curative. Here, we report the case of a 40-year-old woman with BIA-ALCL who presented with unilateral breast swelling in the peripartum period.

Primary Lymphomas of the Breast: A Review

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.