Rarely a woman may develop an anaplastic large cell lymphoma (ALCL) associated with a breast implant.
Features of an ALCL associated with a breast implant:
(1) presence of an effusion (seroma) and/or mass lesion associated with a breast implant
(2) symptoms may include local swelling, pain, rash, pruritis or a sense of pressure
(3) biopsy shows an anaplastic large cell lymphoma (see below)
(4) exclusion of other forms of malignant lymphoma elsewhere (chronic inflammation, systemic ALCL, cutaneous ALCL, CD30-positive lymphoproliferative disorder, etc)
Pathologic features of the ALCL:
(1) large, pleomorphic epithelioid cells with vesicular and irregular nuclei
(2) high mitotic rate
(3) usually strongly positive for CD30
(4) usually EMA positive
(5) usually express T-cell markers
(6) ALK-negative
(7) typically show T-cell receptor gene rearrangements
Clinical Form |
Prognosis |
Management |
effusion only |
good with indolent course |
removal of implant and pseudocapsule |
any mass |
more aggressive |
chemoradiation |
Specialty: Hematology Oncology