Study:Seroma-associated primary anaplastic large-cell lymphoma adjacent to breast implants: an indolent T-cell lymphoproliferative disorder.

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Breast Implant Awareness BlogSeroma-associated primary anaplastic large-cell lymphoma adjacent

to breast implants: an indolent T-cell lymphoproliferative disorder.Roden AC, Macon WR, Keeney GL, Myers JL, Feldman AL, Dogan A.

1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.Non-Hodgkin

lymphomas of the breast are rare, encompassing approximately 0.04-0.5%

of all malignant breast tumors, and the vast majority are B-cell

lymphomas. In contrast, lymphomas of T-cell phenotype have been rarely

reported and some of these have been in close proximity to a breast

implant. In our consultation practice, we have identified four patients

with primary T-cell anaplastic large-cell lymphoma presenting adjacent

to silicone or saline breast implants. All patients presented with

seroma and neoplastic cells were identified in suspension in the serous

fluid without solid tissue invasion. Three patients had no evidence of

systemic disease (stage 1E), and one patient was not staged. The mean

age of the patients was 46 years (range, 34-59 years). In all patients,

the neoplastic cells had a T-cell phenotype, expressed CD30, cytotoxic

granule-associated proteins, EMA and clusterin, and were anaplastic

lymphoma kinase-1-negative. Clonal T-cell receptor gamma-chain gene

rearrangements were identified in three patients. All patients

underwent capsulectomy with removal of the implant. One patient

subsequently received chemotherapy and radiation therapy, and another

was treated with radiation alone. The third patient received no further

therapy and the fourth patient has been recently diagnosed. After a

mean time of 13 months (range, 9-20 months), all three patients with

follow-up were alive and well without any recurrence or systemic

disease. Although the follow-up time was relatively short, our series

and other reported cases suggest that primary anaplastic large-cell

lymphoma adjacent to breast implants is an indolent* T-cell

lymphoproliferative disorder.Modern Pathology advance online

publication, 25 January 2008; doi:10.1038/modpathol.3801024.Indolent:2.Pathology. causing little or no pain; inactive or relatively benign: an indolent ulcer that is not painful and is slow to heal.

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