Département de Pathologie, Institut Universitaire du Cancer de Toulouse, CHU de Toulouse.
Laboratoire d'excellence Toucan, INSERM U.1037, Centre de Recherche en Cancérologie de Toulouse-Purpan, Toulouse.
Curr Opin Oncol. 2018 Sep;30(5):292-300. doi: 10.1097/CCO.0000000000000476.
Breast implant-associated anaplastic large cell lymphoma (BI-ALCL) is a rare form of lymphoma arising adjacent to a breast implant. We aim to review the pathogenesis and clinico-biological features of BI-ALCL.
BI-ALCL is a new provisional entity in the 2017 updated WHO classification. Among several hypotheses, BI-ALCL development seems to be determined by the interaction of immune response related to implant products and additional genetic events.
BI-ALCL is an uncommon T-cell lymphoma which is increasingly diagnosed since its first description in 1997 with 500 estimated cases worldwide. Two BI-ALCL subtypes correlating with clinical presentation have been described. Although most BI-ALCL patients with tumor cell proliferation restricted to the periprosthetic effusion and capsule have excellent outcomes, other patients presenting with a tumor mass, may have a more aggressive disease. The pathogenesis of BI-ALCL remains elusive. It is postulated that local chronic inflammation elicitated by bacterial infection or implant products may promote the activation and proliferation of T cells. Additional genetic events resulting in the activation JAK/STAT pathway are also incriminated. Further investigations are needed to better characterize the pathogenesis of this disease in order to determine the potential risk to develop BI-ALCL after surgical implants.
乳腺假体相关间变大细胞淋巴瘤（BI-ALCL）是一种罕见的发生于假体附近的淋巴瘤。我们旨在综述 BI-ALCL 的发病机制和临床生物学特征。
BI-ALCL 是 2017 年 WHO 分类更新后的一个新的暂定实体。在几个假说中，BI-ALCL 的发展似乎取决于与植入物产品相关的免疫反应和其他遗传事件的相互作用。
BI-ALCL 是一种罕见的 T 细胞淋巴瘤，自 1997 年首次描述以来，其发病率不断增加，全球估计有 500 例。已经描述了两种与临床表现相关的 BI-ALCL 亚型。尽管大多数 BI-ALCL 患者的肿瘤细胞增殖局限于假体周围渗出液和囊内，预后良好，但其他表现为肿瘤肿块的患者可能具有更具侵袭性的疾病。BI-ALCL 的发病机制仍不清楚。据推测，细菌感染或植入物产品引起的局部慢性炎症可能会促进 T 细胞的激活和增殖。此外，还涉及导致 JAK/STAT 通路激活的其他遗传事件。需要进一步的研究来更好地描述这种疾病的发病机制，以便确定在接受手术植入物后发生 BI-ALCL 的潜在风险。
