Seroma-assoc. primary anaplastic large-cell lymphoma adjacent to breast impl

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http://www.nature.com/modpathol/journal/v21/n4/abs/3801024a.html

http://www.nature.com/modpathol/journal/v21/n4/abs/3801024a.html

Modern Pathology

Modern Pathology (2008) 21, 455–463; doi:10.1038/modpathol.3801024; published online 25 January 2008

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

Anja C Roden1, R Macon1, L Keeney1, L Myers2, L Feldman1 and Ahmet Dogan1

1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA

2Department of Pathology, University of Michigan Health System, Ann Arbor, MI, USACorrespondence:Dr A Dogan, MD, PhD, Department of Laboratory Medicine and Pathology,Mayo Clinic, Hilton 11, 200 First Street SW, Rochester, MN 55905, USA.E-mail: Dogan.ahmet@...

Received 7 August 2007; Revised 4 October 2007; Accepted 8 October 2007; Published online 25 January 2008.

Abstract

Non-Hodgkinlymphomas of the breast are rare, encompassing approximately 0.04–0.5%of all malignant breast tumors, and the vast majority are B-celllymphomas. In contrast, lymphomas of T-cell phenotype have been rarelyreported and some of these have been in close proximity to a breastimplant. In our consultation practice, we have identified four patientswith primary T-cell anaplastic large-cell lymphoma presenting adjacentto silicone or saline breast implants. All patients presented withseroma and neoplastic cells were identified in suspension in the serousfluid without solid tissue invasion. Three patients had no evidence ofsystemic disease (stage 1E), and one patient was not staged. The meanage of the patients was 46 years (range, 34–59 years). In all patients,the neoplastic cells had a T-cell phenotype, expressed CD30, cytotoxicgranule-associated proteins, EMA and clusterin, and were anaplasticlymphoma kinase-1-negative. Clonal T-cell receptor -chaingene rearrangements were identified in three patients. All patientsunderwent capsulectomy with removal of the implant. One patientsubsequently received chemotherapy and radiation therapy, and anotherwas treated with radiation alone. The third patient received no furthertherapy and the fourth patient has been recently diagnosed. After amean time of 13 months (range, 9–20 months), all three patients withfollow-up were alive and well without any recurrence or systemicdisease. Although the follow-up time was relatively short, our seriesand other reported cases suggest that primary anaplastic large-celllymphoma adjacent to breast implants is an indolent T-celllymphoproliferative disorder.

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