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硅胶诱导的乳房植入物包膜肉芽肿(SIGBIC):与间变性大细胞淋巴瘤(ALCL)的异同及其鉴别诊断

Silicone-induced granuloma of breast implant capsule (SIGBIC): similarities and differences with anaplastic large cell lymphoma (ALCL) and their differential diagnosis.

作者信息

Fleury Eduardo de Faria Castro, Rêgo Milena Morais, Ramalho Luciana Costa, Ayres Veronica Jorge, Seleti Rodrigo Oliveira, Ferreira Carlos Alberto Pecci, Roveda Decio

机构信息

Radiology Department, IBCC - Instituto Brasileiro de Controle do Câncer.

Irmandade Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.

出版信息

Breast Cancer (Dove Med Press). 2017 Mar 10;9:133-140. doi: 10.2147/BCTT.S126003. eCollection 2017.

Abstract

Primary breast lymphoma is a rare disease and accounts for 0.5% of cases of breast cancer. Most primary breast lymphomas develop from B cells, and the involvement of T cells is rare. Anaplastic large cell lymphoma (ALCL) is a recently discovered T-cell lymphoma associated with breast implants. Only a few cases have been reported to date. It is believed that the incidence of ALCL is increasing because of the increasing number of breast implants. The clinical presentation is variable and can manifest as a palpable mass in the breast or armpit, breast pain, or capsular contracture. Because of the rarity of the disease and the lack of knowledge to date, clinical diagnosis is often delayed, with consequent delays in treatment. The cause and pathogenesis have not been fully elucidated, and there are no evidence-based guidelines for diagnosis, treatment, or follow-up of this disease. We present a review of cases of patients with silicone breast implants, including ALCL, a rare type of breast cancer that is still under study, and silicone-induced granuloma of breast implant capsule and its differential diagnosis, and discuss if a silicone-induced granuloma of breast implant capsule could be the precursor of the disease.

摘要

原发性乳腺淋巴瘤是一种罕见疾病,占乳腺癌病例的0.5%。大多数原发性乳腺淋巴瘤起源于B细胞,T细胞受累罕见。间变性大细胞淋巴瘤(ALCL)是一种最近发现的与乳房植入物相关的T细胞淋巴瘤。迄今为止,仅报道了少数病例。据信,由于乳房植入物数量的增加,ALCL的发病率正在上升。临床表现多样,可表现为乳房或腋窝可触及的肿块、乳房疼痛或包膜挛缩。由于该疾病罕见且目前缺乏相关认识,临床诊断常常延迟,进而导致治疗延误。病因和发病机制尚未完全阐明,对于该疾病的诊断、治疗或随访尚无循证指南。我们对硅胶乳房植入物患者的病例进行综述,包括仍在研究中的罕见乳腺癌类型ALCL、硅胶诱导的乳房植入物包膜肉芽肿及其鉴别诊断,并讨论硅胶诱导的乳房植入物包膜肉芽肿是否可能是该疾病的前驱病变。

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