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Hum Pathol. 2018 Aug;78:54-62. doi: 10.1016/j.humpath.2018.04.007. Epub 2018 Apr 22.

IL-13 is produced by tumor cells in breast implant-associated anaplastic large cell lymphoma: implications for pathogenesis.

Author information

1
Roger Williams Medical Center, Providence, RI 02908. Electronic address: mkadin@me.com.
2
Roger Williams Medical Center, Providence, RI 02908.
3
USC Keck School of Medicine, Los Angeles, CA 90033.
4
Sieber Plastic Surgery, San Francisco, CA 94904.
5
Dallas Plastic Surgery Institute, Dallas, TX 75231.
6
UT Southwestern Department of Plastic Surgery, Dallas 75205.
7
Bacchi Pathology Laboratory, San Paolo, Brazil 18602-010.
8
Inst Bras Controle Câncer, San Paolo, Brazil 04536-010.
9
Plastic Surgery Division, MD Anderson Cancer Center, Houston, TX 77030.
10
Hematopathology Division, MD Anderson Cancer Center, Houston, TX 77030.

Abstract

More than 500 women worldwide have developed a CD30+ T-cell lymphoma around breast implants, strongly suggesting a cause-and-effect relationship, and designated as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). The mechanism of lymphomagenesis is unknown. Recently, a bacterial biofilm containing gram-negative bacilli was discovered on the surface of breast implants associated with ALCL. We and others have described overexpression of the proto-oncogene JUNB and mutations of JAK1/2, TP53 and STAT3 in BIA-ALCL. Here we report that BIA-ALCL cell lines and anaplastic lymphoma cells in clinical specimens produce IL-13, the signature cytokine of allergic inflammation. Supporting the link of BIA-ALCL to allergic inflammation, lymphoma cells were often surrounded by eosinophils and mast cells, features typically absent in systemic ALCL. Because of the link of IL-13 to allergy, we looked for IgE and found it decorating the surface of mast cells and antigen-presenting follicular dendritic cells in capsules and lymph nodes infiltrated by anaplastic lymphoma cells, but not uninvolved capsules. Plasma cells within capsules and regional lymph nodes were identified as a possible source of IgE. Together, these findings suggest the hypothesis that an amplified immune response with features of a chronic allergic reaction in a susceptible patient underlies the pathogenesis of BIA-ALCL.

KEYWORDS:

BIA-ALCL; Breast implants; Breast implant–associated anaplastic large cell lymphoma; IL-13; Lymphomagenesis

PMID:
29689246
DOI:
10.1016/j.humpath.2018.04.007
[Indexed for MEDLINE]

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