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Diagnostic challenges and potential early indicators of breast periprosthetic anaplastic large cell lymphoma: A case report

RATIONALE: Anaplastic large T-cell lymphoma (BI-ALCL) is a rare primitive lymphoma described in women with breast implant prostheses, which has been arousing interest in recent years due to its potentially high social impact. The difficult diagnosis associated with the high and increasing number of...

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Autores principales: La Forgia, Daniele, Catino, Annamaria, Fausto, Alfonso, Cutrignelli, Daniela, Fanizzi, Annarita, Gatta, Gianluca, Losurdo, Liliana, Maiorella, Arianna, Moschetta, Marco, Ressa, Cosmo, Scattone, Anna, Portincasa, Aurelio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer Health 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387005/
https://www.ncbi.nlm.nih.gov/pubmed/32791685
http://dx.doi.org/10.1097/MD.0000000000021095
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author La Forgia, Daniele
Catino, Annamaria
Fausto, Alfonso
Cutrignelli, Daniela
Fanizzi, Annarita
Gatta, Gianluca
Losurdo, Liliana
Maiorella, Arianna
Moschetta, Marco
Ressa, Cosmo
Scattone, Anna
Portincasa, Aurelio
author_facet La Forgia, Daniele
Catino, Annamaria
Fausto, Alfonso
Cutrignelli, Daniela
Fanizzi, Annarita
Gatta, Gianluca
Losurdo, Liliana
Maiorella, Arianna
Moschetta, Marco
Ressa, Cosmo
Scattone, Anna
Portincasa, Aurelio
author_sort La Forgia, Daniele
collection PubMed
description RATIONALE: Anaplastic large T-cell lymphoma (BI-ALCL) is a rare primitive lymphoma described in women with breast implant prostheses, which has been arousing interest in recent years due to its potentially high social impact. The difficult diagnosis associated with the high and increasing number of prosthetic implants worldwide has led to hypothesize an underestimation of the real impact of the disease among prosthesis-bearing women. The aim of this work is to search for specific radiological signs of disease linked to the chronic inflammatory pathogenetic mechanism. PATIENT CONCERNS: This work describes a case of BI-ALCL in an American woman with no personal or family history of cancer, who underwent breast augmentation for esthetic purposes at our Institute. After about 10 years of relative well-being, the patient returned to our Institute with clear evidence of breast asymmetry due to the increase in volume of the right breast which had progressively become larger over a period of 6 months. There was no evidence of palpable axillary lymph nodes or other noteworthy signs. DIAGNOSIS: The ultrasound and magnetic resonance (MR) tests indicated the presence of seroma with amorphous material in the exudate which was confirmed by indirect signs, visible in right breast mammography. Due to suspected cold seroma, an ultrasound-guided needle aspiration was performed for the cytological analysis of the effusion which highlighted the presence of a number of large-sized atypical cells with an irregular nucleus with CD30 immunoreactivity, leucocyte common antigen (CD45) compatible with the BI-ALCL diagnosis. INTERVENTIONS: In our case, a capsulectomy was performed because the disease was limited inside the capsule and periprosthetic seroma. The final histological examination confirmed the stage. LESSONS: The patient is being monitored and shows no signs of recurrence of disease >24 months after surgery. CONCLUSION: A diagnosis of BI-ALCL can be reached using new radiological indicators, such as fibrin, which is clearly visible by MR in the form of nonvascularized debris of amorphous material hypointense in all sequences, free flowing or adhered to the external surface of the prosthesis.
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spelling pubmed-73870052020-08-05 Diagnostic challenges and potential early indicators of breast periprosthetic anaplastic large cell lymphoma: A case report La Forgia, Daniele Catino, Annamaria Fausto, Alfonso Cutrignelli, Daniela Fanizzi, Annarita Gatta, Gianluca Losurdo, Liliana Maiorella, Arianna Moschetta, Marco Ressa, Cosmo Scattone, Anna Portincasa, Aurelio Medicine (Baltimore) 5700 RATIONALE: Anaplastic large T-cell lymphoma (BI-ALCL) is a rare primitive lymphoma described in women with breast implant prostheses, which has been arousing interest in recent years due to its potentially high social impact. The difficult diagnosis associated with the high and increasing number of prosthetic implants worldwide has led to hypothesize an underestimation of the real impact of the disease among prosthesis-bearing women. The aim of this work is to search for specific radiological signs of disease linked to the chronic inflammatory pathogenetic mechanism. PATIENT CONCERNS: This work describes a case of BI-ALCL in an American woman with no personal or family history of cancer, who underwent breast augmentation for esthetic purposes at our Institute. After about 10 years of relative well-being, the patient returned to our Institute with clear evidence of breast asymmetry due to the increase in volume of the right breast which had progressively become larger over a period of 6 months. There was no evidence of palpable axillary lymph nodes or other noteworthy signs. DIAGNOSIS: The ultrasound and magnetic resonance (MR) tests indicated the presence of seroma with amorphous material in the exudate which was confirmed by indirect signs, visible in right breast mammography. Due to suspected cold seroma, an ultrasound-guided needle aspiration was performed for the cytological analysis of the effusion which highlighted the presence of a number of large-sized atypical cells with an irregular nucleus with CD30 immunoreactivity, leucocyte common antigen (CD45) compatible with the BI-ALCL diagnosis. INTERVENTIONS: In our case, a capsulectomy was performed because the disease was limited inside the capsule and periprosthetic seroma. The final histological examination confirmed the stage. LESSONS: The patient is being monitored and shows no signs of recurrence of disease >24 months after surgery. CONCLUSION: A diagnosis of BI-ALCL can be reached using new radiological indicators, such as fibrin, which is clearly visible by MR in the form of nonvascularized debris of amorphous material hypointense in all sequences, free flowing or adhered to the external surface of the prosthesis. Wolters Kluwer Health 2020-07-24 /pmc/articles/PMC7387005/ /pubmed/32791685 http://dx.doi.org/10.1097/MD.0000000000021095 Text en Copyright © 2020 the Author(s). Published by Wolters Kluwer Health, Inc. http://creativecommons.org/licenses/by/4.0 This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0
spellingShingle 5700
La Forgia, Daniele
Catino, Annamaria
Fausto, Alfonso
Cutrignelli, Daniela
Fanizzi, Annarita
Gatta, Gianluca
Losurdo, Liliana
Maiorella, Arianna
Moschetta, Marco
Ressa, Cosmo
Scattone, Anna
Portincasa, Aurelio
Diagnostic challenges and potential early indicators of breast periprosthetic anaplastic large cell lymphoma: A case report
title Diagnostic challenges and potential early indicators of breast periprosthetic anaplastic large cell lymphoma: A case report
title_full Diagnostic challenges and potential early indicators of breast periprosthetic anaplastic large cell lymphoma: A case report
title_fullStr Diagnostic challenges and potential early indicators of breast periprosthetic anaplastic large cell lymphoma: A case report
title_full_unstemmed Diagnostic challenges and potential early indicators of breast periprosthetic anaplastic large cell lymphoma: A case report
title_short Diagnostic challenges and potential early indicators of breast periprosthetic anaplastic large cell lymphoma: A case report
title_sort diagnostic challenges and potential early indicators of breast periprosthetic anaplastic large cell lymphoma: a case report
topic 5700
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7387005/
https://www.ncbi.nlm.nih.gov/pubmed/32791685
http://dx.doi.org/10.1097/MD.0000000000021095
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