de Boer Mintsje, van der Sluis Wouter B, de Boer Jan P, Overbeek Lucy I H, van Leeuwen Flora E, Rakhorst Hinne A, van der Hulst René R W J, Hijmering Nathalie J, Bouman Mark-Bram, de Jong Daphne
Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center, Maastricht, the Netherlands. Department of Plastic, Reconstructive, and Hand Surgery, VU University Medical Center, Amsterdam, the Netherlands. Department of Oncology, Netherlands Cancer Institute, Amsterdam. Dutch Nationwide Network and Registry of Histo- and Cytopathology, Houten, the Netherlands. Division of Epidemiology, Netherlands Cancer Institute, Amsterdam. Department of Plastic, Reconstructive, and Hand Surgery, MST, Enschede, the Netherlands, Dutch Society of Plastic Surgery. Division of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center. Department of Pathology, VU University Medical Center. Department of Plastic, Reconstructive, and Hand Surgery, VU University Medical Center. Center of Expertise on Gender Dysphoria at the VU University Medical Center. Division of Pathology, VU University Medical Center. Dutch BIA-ALCL Consortium.
Aesthet Surg J. 2017 Sep 1;37(8):NP83-NP87. doi: 10.1093/asj/sjx098.
Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare but serious complication in patients with breast implants, Patients are at risk of BIA-ALCL whether they receive breast implants for cosmetic reasons or for reconstructive purposes after surgery for breast cancer or prophylactic mastectomy. During the past decade, an increased number of reports have addressed BIA-ALCL. Herein, we describe BIA-ALCL in a transgender woman. The patient received breast implants as part of her gender transition and was diagnosed with BIA-ALCL 20 years later. The patient underwent several revisional operations in the 20 years after her primary breast surgery to treat unexplained pain with low-grade fever, severe capsular contracture (Baker grade III-IV), and several instances of implant rupture. In July 2016, the patient presented to our office with "late-onset" periprosthetic seroma 5 years after her last revisional breast surgery. She was diagnosed with BIA-ALCL without capsular invasion based on results of cytologic analysis of the periprosthetic seroma and histologic evaluation of the periprosthetic capsule. This diagnosis was verified further by results of immunohistochemical testing, which indicated expression of CD30 and T-cell markers in the periprosthetic seroma only. Our intentions with this case report are to demonstrate that all patients who undergo breast implantation, including transgender women, are at risk of BIA-ALCL and to highlight the importance of cytomorphologic and immunohistochemical screening of seroma fluid in patients with late-onset periprosthetic seroma.
乳房植入物相关间变性大细胞淋巴瘤（BIA-ALCL）是乳房植入物患者中一种罕见但严重的并发症，无论患者是出于美容原因接受乳房植入物，还是在乳腺癌手术或预防性乳房切除术后出于重建目的接受乳房植入物，都有患BIA-ALCL的风险。在过去十年中，关于BIA-ALCL的报道数量有所增加。在此，我们描述一名 transgender 女性中的BIA-ALCL。该患者接受乳房植入物作为其性别转换的一部分，并在20年后被诊断为BIA-ALCL。在初次乳房手术后的20年里，该患者接受了几次翻修手术，以治疗不明原因的疼痛伴低热、严重包膜挛缩（贝克分级III-IV级）以及几次植入物破裂情况。2016年7月，该患者在最后一次乳房翻修手术后5年因“迟发性”假体周围血清肿前来我院就诊。根据假体周围血清肿的细胞学分析结果和假体周围包膜的组织学评估，她被诊断为无包膜侵犯的BIA-ALCL。免疫组化检测结果进一步证实了这一诊断，该结果表明仅在假体周围血清肿中表达CD30和T细胞标志物。我们撰写本病例报告的目的是证明所有接受乳房植入的患者，包括transgender女性，都有患BIA-ALCL的风险，并强调对迟发性假体周围血清肿患者的血清肿液进行细胞形态学和免疫组化筛查的重要性。
5级。
