Patzelt Matej, Zarubova Lucie, Klener Pavel, Barta Josef, Benkova Kamila, Brandejsova Adrianna, Trneny Marek, Gürlich Robert, Sukop Andrej
Department of Plastic Surgery, Royal Vinohrady Teaching Hospital, Srobarova 1150/50, 100 34, Prague, Czech Republic.
Third Faculty of Medicine, Charles University, Ruska 87, 100 00, Prague, Czech Republic.
Aesthetic Plast Surg. 2018 Apr;42(2):451-455. doi: 10.1007/s00266-017-1012-y. Epub 2017 Nov 3.
Breast implant-associated anaplastic large-cell lymphoma (BIA-ALCL) is a rare peripheral T cell lymphoma. BIA-ALCL is a disease of the fibrous capsule surrounding the implant and occurs in patients after both breast reconstruction and augmentation. More than 300 cases have been reported so far, including two in a transgender patient. Here we describe BIA-ALCL presented with a mass in a transgender patient and the first case of BIA-ALCL in the Czech Republic. In 2007, a 33-year-old transgender male to female underwent bilateral breast augmentation as a part of his transformation to female. In June 2014, the patient developed a 5-cm tumorous mass in her left breast. Magnetic resonance imaging of the chest revealed a ruptured implant and a tumorous mass penetrating into the capsule and infiltrating the pectoral muscle. An R0 surgery was indicated-the implant, silicone gel and capsule were removed, and the tumorous mass was resected together with a part of the pectoral muscle. Histology revealed anaplastic large-cell lymphoma. The patient underwent standard staging procedures for lymphoma including a bone marrow trephine biopsy, which confirmed stage IE. The patient was treated with the standard chemotherapy for systemic ALCL-6 cycles of CHOP-21. The patient was tumor-free at the 2-year follow-up. BIA-ALCL has been reported mostly in women who received implants for either reconstructive or aesthetic augmentation. This is the third report of BIA-ALCL in a transgender person, the first in the Czech Republic. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
乳房植入物相关间变性大细胞淋巴瘤（BIA-ALCL）是一种罕见的外周T细胞淋巴瘤。BIA-ALCL是一种发生于植入物周围纤维囊的疾病，在乳房重建和隆胸术后的患者中均可出现。迄今为止，已报道300多例病例，其中包括1例变性者。在此，我们描述了1例表现为肿块的变性者BIA-ALCL病例，这也是捷克共和国首例BIA-ALCL病例。2007年，一名33岁的变性男性（男变女）为完成女性化转变接受了双侧隆胸手术。2014年 June，该患者左侧乳房出现一个5厘米的肿瘤性肿块。胸部磁共振成像显示植入物破裂，肿瘤性肿块穿透包膜并浸润胸肌。遂行R0手术——取出植入物、硅胶和包膜，连同部分胸肌一并切除肿瘤性肿块。组织学检查显示为间变性大细胞淋巴瘤。患者接受了淋巴瘤的标准分期检查，包括骨髓穿刺活检，确诊为IE期。患者接受了系统性ALCL的标准化疗——6个周期的CHOP-21方案。在2年的随访中，患者无肿瘤复发。BIA-ALCL大多报道于接受重建或美容隆胸植入物的女性。这是第三例变性者BIA-ALCL报道，也是捷克共和国首例。证据级别V 本刊要求作者为每篇文章指定证据级别。有关这些循证医学评级的完整描述，请参阅目录或作者在线指南www.springer.com/00266 。
