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Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma

Late breast implant seroma may be the presentation of a breast implant-associated anaplastic large cell lymphoma (BI-ALCL), which claims for a prompt recognition. However, BI-ALCL diagnosis on fine-needle aspiration (FNA) might be challenging for pathologists lacking experience with peri-implant bre...

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Autores principales: Di Napoli, Arianna, Pepe, Giuseppina, Giarnieri, Enrico, Cippitelli, Claudia, Bonifacino, Adriana, Mattei, Mauro, Martelli, Maurizio, Falasca, Carlo, Cox, Maria Christina, Santino, Iolanda, Giovagnoli, Maria Rosaria
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513491/
https://www.ncbi.nlm.nih.gov/pubmed/28715445
http://dx.doi.org/10.1371/journal.pone.0181097
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author Di Napoli, Arianna
Pepe, Giuseppina
Giarnieri, Enrico
Cippitelli, Claudia
Bonifacino, Adriana
Mattei, Mauro
Martelli, Maurizio
Falasca, Carlo
Cox, Maria Christina
Santino, Iolanda
Giovagnoli, Maria Rosaria
author_facet Di Napoli, Arianna
Pepe, Giuseppina
Giarnieri, Enrico
Cippitelli, Claudia
Bonifacino, Adriana
Mattei, Mauro
Martelli, Maurizio
Falasca, Carlo
Cox, Maria Christina
Santino, Iolanda
Giovagnoli, Maria Rosaria
author_sort Di Napoli, Arianna
collection PubMed
description Late breast implant seroma may be the presentation of a breast implant-associated anaplastic large cell lymphoma (BI-ALCL), which claims for a prompt recognition. However, BI-ALCL diagnosis on fine-needle aspiration (FNA) might be challenging for pathologists lacking experience with peri-implant breast effusions. Sixty-seven late breast implant seromas collected by FNA from 50 patients were evaluated by Papanicolaou smear stain and immunocytochemistry on cell blocks. A diagnostic algorithm based on the cellular composition, cell morphology and percentage of CD30(+) cells was developed. Histological evaluation of the corresponding peri-prosthetic capsules was also performed. Most of the effusions (91% of the samples) were classified as reactive and 9% as BI-ALCL. In the BI-ALCL cases, medium-to-large atypical cells expressing CD30 represented more than 70% of the cellularity, whereas in in the reactive effusions CD30(+) elements were extremely rare (<5%) and consisted of non-atypical elements. The reactive effusions were categorized into three patterns: i) acute infiltrate with prominent neutrophilic component (33% of the samples); ii) mixed infiltrate characterized by a variable number of neutrophils, lymphocytes and macrophages (30% of the samples); iii) chronic infiltrate composed predominantly of T lymphocytes or macrophages with only sporadic granulocytes (37% of the samples). The inflammatory cytological patterns were consistent with the histology of the corresponding capsules. Our results indicate that cytological analysis of late breast implant effusions, supported by the knowledge of the heterogeneous cytomorphological spectrum of late seromas, is a valuable approach for the early recognition of BI-ALCL.
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spelling pubmed-55134912017-08-07 Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma Di Napoli, Arianna Pepe, Giuseppina Giarnieri, Enrico Cippitelli, Claudia Bonifacino, Adriana Mattei, Mauro Martelli, Maurizio Falasca, Carlo Cox, Maria Christina Santino, Iolanda Giovagnoli, Maria Rosaria PLoS One Research Article Late breast implant seroma may be the presentation of a breast implant-associated anaplastic large cell lymphoma (BI-ALCL), which claims for a prompt recognition. However, BI-ALCL diagnosis on fine-needle aspiration (FNA) might be challenging for pathologists lacking experience with peri-implant breast effusions. Sixty-seven late breast implant seromas collected by FNA from 50 patients were evaluated by Papanicolaou smear stain and immunocytochemistry on cell blocks. A diagnostic algorithm based on the cellular composition, cell morphology and percentage of CD30(+) cells was developed. Histological evaluation of the corresponding peri-prosthetic capsules was also performed. Most of the effusions (91% of the samples) were classified as reactive and 9% as BI-ALCL. In the BI-ALCL cases, medium-to-large atypical cells expressing CD30 represented more than 70% of the cellularity, whereas in in the reactive effusions CD30(+) elements were extremely rare (<5%) and consisted of non-atypical elements. The reactive effusions were categorized into three patterns: i) acute infiltrate with prominent neutrophilic component (33% of the samples); ii) mixed infiltrate characterized by a variable number of neutrophils, lymphocytes and macrophages (30% of the samples); iii) chronic infiltrate composed predominantly of T lymphocytes or macrophages with only sporadic granulocytes (37% of the samples). The inflammatory cytological patterns were consistent with the histology of the corresponding capsules. Our results indicate that cytological analysis of late breast implant effusions, supported by the knowledge of the heterogeneous cytomorphological spectrum of late seromas, is a valuable approach for the early recognition of BI-ALCL. Public Library of Science 2017-07-17 /pmc/articles/PMC5513491/ /pubmed/28715445 http://dx.doi.org/10.1371/journal.pone.0181097 Text en © 2017 Di Napoli et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Di Napoli, Arianna
Pepe, Giuseppina
Giarnieri, Enrico
Cippitelli, Claudia
Bonifacino, Adriana
Mattei, Mauro
Martelli, Maurizio
Falasca, Carlo
Cox, Maria Christina
Santino, Iolanda
Giovagnoli, Maria Rosaria
Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma
title Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma
title_full Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma
title_fullStr Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma
title_full_unstemmed Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma
title_short Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma
title_sort cytological diagnostic features of late breast implant seromas: from reactive to anaplastic large cell lymphoma
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513491/
https://www.ncbi.nlm.nih.gov/pubmed/28715445
http://dx.doi.org/10.1371/journal.pone.0181097
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