Format

Send to

Choose Destination
Ann Oncol. 2016 Feb;27(2):306-14. doi: 10.1093/annonc/mdv575. Epub 2015 Nov 23.

Breast implant-associated anaplastic large cell lymphoma: two distinct clinicopathological variants with different outcomes.

Author information

1
Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse INSERM, U.1037, Centre de recherche en cancérologie de Toulouse-Purpan, Toulouse laurent.c@chu-toulouse.fr.
2
Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse.
3
Department of Pathology, AP-HP, Groupe hospitalier Henri Mondor-Albert Chenevier, Créteil INSERM U955, Université Paris-Est, Créteil.
4
INSERM U955, Université Paris-Est, Créteil Lymphoid Malignancies Unit, AP-HP, Groupe hospitalier Henri Mondor-Albert Chenevier, Créteil.
5
Department of Pathology, Centre Hospitalier Hôtel Dieu, Nantes.
6
Department of Pathology, Institut Paoli-Calmettes, Marseille.
7
Department of Pathology, Centre Hospitalier Lyon-Sud, Lyon.
8
Department of Pathology, Hôpital Gui de Chauliac-Saint Eloi, Montpellier.
9
Department of Pathology, Centre Hospitalier de Brest, Brest, France.
10
Département de Pathologie, Montréal, Canada.
11
Department of Pathology, Hôpital Ambroise Paré, Boulogne.
12
Department of Pathology, Hôpital Hautepierre, Strasbourg.
13
Department of Pathology, Centre Hospitalier Henri Duffaut, Avignon.
14
Department of Pathology, Hôpital René Huguenin, Saint Cloud.
15
Histo-Pathology Institut, Nantes.
16
Department of Pathology, Hôpital Nord, Marseille.
17
Department of Pathology, Centre Hospitalier Pasteur L'Archet, Nice.
18
Department of Pathology, Centre Léon Bérard, Lyon, France.
19
Pathology institut of Lausanne, Centre Hospitalier Universitaire Vaudois, Suisse, Lausanne, Switzerland.
20
Department of Pathology, Institut Universitaire du Cancer-Oncopole, Toulouse INSERM, U.1037, Centre de recherche en cancérologie de Toulouse-Purpan, Toulouse.

Abstract

BACKGROUND:

ALK-negative anaplastic large cell lymphoma associated with breast implant (i-ALCL) has been recently recognized as a distinct entity. Among 43 830 lymphomas registered in the French Lymphopath network since 2010, 300 breast lymphomas comprising 25 peripheral T-cell lymphomas (PTCL) were reviewed. Among PTCL, ALK-negative ALCL was the most frequent and all of them were associated with breast implants.

PATIENTS AND METHODS:

Since 2010, all i-ALCL cases were collected from different institutions through Lymphopath. Immuno-morphologic features, molecular data and clinical outcome of 19 i-ALCLs have been retrospectively analyzed.

RESULTS:

The median age of the patients was 61 years and the median length between breast implant and i-ALCL was 9 years. Most implants were silicone-filled and textured. Implant removal was performed in 17 out of 19 patients with additional treatment based on mostly CHOP or CHOP-like chemotherapy regimens (n = 10/19) or irradiation (n = 1/19). CHOP alone or ABVD following radiation without implant removal have been given in two patients. The two clinical presentations, i.e. effusion and less frequently tumor mass correlated with distinct histopathologic features: in situ i-ALCL (anaplastic cell proliferation confined to the fibrous capsule) and infiltrative i-ALCL (pleomorphic cells massively infiltrating adjacent tissue with eosinophils and sometimes Reed-Sternberg-like cells mimicking Hodgkin lymphoma). Malignant cells were CD30-positive, showed a variable staining for EMA and were ALK negative. Most cases had a cytotoxic T-cell immunophenotype with variable T-cell antigen loss and pSTAT3 nuclear expression. T-cell receptor genes were clonally rearranged in 13 out of 13 tested cases. After 18 months of median follow-up, the 2-year overall survival for in situ and infiltrative i-ALCL was 100% and 52.5%, respectively.

CONCLUSIONS:

In situ i-ALCLs have an indolent clinical course and generally remain free of disease after implant removal. However, infiltrative i-ALCLs could have a more aggressive clinical course that might require additional therapy to implant removal.

KEYWORDS:

anaplastic/Hodgkin-like subtypes; cytotoxic T-cell; implant-ALCL; mass; seroma

PMID:
26598546
PMCID:
PMC4722894
DOI:
10.1093/annonc/mdv575
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Silverchair Information Systems Icon for PubMed Central
Loading ...
Support Center