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
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Clinical Form
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Prognosis
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Management
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effusion only
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good with indolent course
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removal of implant and pseudocapsule
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any mass
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more aggressive
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chemoradiation
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