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Breast implant associated anaplastic large cell lymphoma: Evidence for an efficient diagnostic workup
INTRODUCTION: During the last few years it has been shown that an anaplastic T cell lymphoma can develop as a rare and late sequelae of implant-based breast reconstruction. This malignancy was recognized in the 2017 by WHO and named breast implant associated anaplastic large T cell lymphoma (BIA-ALC...
Autores principales: | , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540484/ https://www.ncbi.nlm.nih.gov/pubmed/36942354 http://dx.doi.org/10.1177/03008916231157837 |
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author | Vittoria, Laura Sala, Laura Summo, Valeria Capone, Iolanda Conca, Elena Toma, Martina Ottolenghi, Joseph Testa, Francesca Cortinovis, Umberto Paolini, Biagio Cabras, Antonello Aiello, Antonella Bozzi, Fabio |
author_facet | Vittoria, Laura Sala, Laura Summo, Valeria Capone, Iolanda Conca, Elena Toma, Martina Ottolenghi, Joseph Testa, Francesca Cortinovis, Umberto Paolini, Biagio Cabras, Antonello Aiello, Antonella Bozzi, Fabio |
author_sort | Vittoria, Laura |
collection | PubMed |
description | INTRODUCTION: During the last few years it has been shown that an anaplastic T cell lymphoma can develop as a rare and late sequelae of implant-based breast reconstruction. This malignancy was recognized in the 2017 by WHO and named breast implant associated anaplastic large T cell lymphoma (BIA-ALCL). BIA-ALCL usually presents as abundant effusion around the implant, thus, in addition to cytology smears, its diagnosis also requires immunohistochemistry, T cells clonality and cytometry. Due to the increasing attention of clinicians, it is likely that the number of the BIA-ALCL suspected cases will grow in the future, implying the necessity of a reliable and cost-effective diagnostic procedure. METHODS: To achieve this goal, we retrospectively analyzed the results of laboratory investigations performed at our Institute (Fondazione IRCCS Istituto Nazionale dei Tumori Milan, Italy) on 44 effusions obtained from 31 women suspected for BIA-ALCL. RESULTS: Through cytology, eight out of 44 effusions showed the presence of BIA-ALCL cells. Lymphoma cells were than confirmed in seven samples by immunohistochemistry and/or T cell clonality and/or cytometry. Overall, cytology showed 100% sensitivity, 97% specificity and positive and negative predictive values of 87.5% and 100% respectively. Further analyses were particularly useful in effusions showing small percentages of BIA-ALCL cells. Moreover, an extended cytometric profile that can be applied when fast confirmation of the cytologic result is required was also identified. CONCLUSIONS: Our results evidenced a central role of cytopathology in the management of BIA-ALCL suspected effusions and suggested that further laboratory investigations might be applied only in cases showing atypical/activated lymphoid cells through cytology. |
format | Online Article Text |
id | pubmed-10540484 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-105404842023-09-30 Breast implant associated anaplastic large cell lymphoma: Evidence for an efficient diagnostic workup Vittoria, Laura Sala, Laura Summo, Valeria Capone, Iolanda Conca, Elena Toma, Martina Ottolenghi, Joseph Testa, Francesca Cortinovis, Umberto Paolini, Biagio Cabras, Antonello Aiello, Antonella Bozzi, Fabio Tumori Original Research Articles INTRODUCTION: During the last few years it has been shown that an anaplastic T cell lymphoma can develop as a rare and late sequelae of implant-based breast reconstruction. This malignancy was recognized in the 2017 by WHO and named breast implant associated anaplastic large T cell lymphoma (BIA-ALCL). BIA-ALCL usually presents as abundant effusion around the implant, thus, in addition to cytology smears, its diagnosis also requires immunohistochemistry, T cells clonality and cytometry. Due to the increasing attention of clinicians, it is likely that the number of the BIA-ALCL suspected cases will grow in the future, implying the necessity of a reliable and cost-effective diagnostic procedure. METHODS: To achieve this goal, we retrospectively analyzed the results of laboratory investigations performed at our Institute (Fondazione IRCCS Istituto Nazionale dei Tumori Milan, Italy) on 44 effusions obtained from 31 women suspected for BIA-ALCL. RESULTS: Through cytology, eight out of 44 effusions showed the presence of BIA-ALCL cells. Lymphoma cells were than confirmed in seven samples by immunohistochemistry and/or T cell clonality and/or cytometry. Overall, cytology showed 100% sensitivity, 97% specificity and positive and negative predictive values of 87.5% and 100% respectively. Further analyses were particularly useful in effusions showing small percentages of BIA-ALCL cells. Moreover, an extended cytometric profile that can be applied when fast confirmation of the cytologic result is required was also identified. CONCLUSIONS: Our results evidenced a central role of cytopathology in the management of BIA-ALCL suspected effusions and suggested that further laboratory investigations might be applied only in cases showing atypical/activated lymphoid cells through cytology. SAGE Publications 2023-03-20 2023-10 /pmc/articles/PMC10540484/ /pubmed/36942354 http://dx.doi.org/10.1177/03008916231157837 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Research Articles Vittoria, Laura Sala, Laura Summo, Valeria Capone, Iolanda Conca, Elena Toma, Martina Ottolenghi, Joseph Testa, Francesca Cortinovis, Umberto Paolini, Biagio Cabras, Antonello Aiello, Antonella Bozzi, Fabio Breast implant associated anaplastic large cell lymphoma: Evidence for an efficient diagnostic workup |
title | Breast implant associated anaplastic large cell lymphoma: Evidence for an efficient diagnostic workup |
title_full | Breast implant associated anaplastic large cell lymphoma: Evidence for an efficient diagnostic workup |
title_fullStr | Breast implant associated anaplastic large cell lymphoma: Evidence for an efficient diagnostic workup |
title_full_unstemmed | Breast implant associated anaplastic large cell lymphoma: Evidence for an efficient diagnostic workup |
title_short | Breast implant associated anaplastic large cell lymphoma: Evidence for an efficient diagnostic workup |
title_sort | breast implant associated anaplastic large cell lymphoma: evidence for an efficient diagnostic workup |
topic | Original Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540484/ https://www.ncbi.nlm.nih.gov/pubmed/36942354 http://dx.doi.org/10.1177/03008916231157837 |
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