Keck Hospital of University of Southern California, Los Angeles, CA.
Aesthet Surg J. 2019 Jun 21;39(7):NP253-NP258. doi: 10.1093/asj/sjz044.
Anaplastic large-cell lymphoma (ALCL) is a very rare but life-threatening complication that has largely been demonstrated to be associated with breast implants (BIA-ALCL). Patients are at risk of BIA-ALCL with the placement of breast implants for either cosmetic or reconstructive purposes, with the highest risks associated with textured breast implants. In the past decade, an increasing number of publications have focused on BIA-ALCL, but there has yet to be a reported case outside of the breast. Here, we describe a unique instance of gluteal implant-associated ALCL (GIA-ALCL) in a middle-aged woman. The patient received bilateral textured silicone gluteal implants only a year prior to her diagnosis of GIA-ALCL. The patient later presented to the Plastic and Reconstructive Surgery Department at our institution with ulceration at the site of her gluteal implants. Unfortunately, her condition deteriorated before explanation could be performed. Biopsy of a left lung mass demonstrated "hallmark" cells of ALCL ("horseshoe"-shaped nuclei). The diagnosis was verified by immunohistochemical testing that revealed expression of CD30, CD4, CD43, BCL6, Perforin, and Ki67 in a population of abnormal cells. The goals of this case report are thus to demonstrate that all patients undergoing implantation of textured silicone implants are at risk of developing ALCL and to provide evidence for the possible new diagnosis of GIA-ALCL. Level of Evidence: 5.
间变大细胞淋巴瘤（ALCL）是一种非常罕见但危及生命的并发症，主要与乳房植入物（BIA-ALCL）有关。无论出于美容还是重建目的，乳房植入物的植入都会使患者面临 BIA-ALCL 的风险，其中纹理乳房植入物的风险最高。在过去的十年中，越来越多的出版物集中在 BIA-ALCL 上，但尚未有报道称其发生在乳房以外的部位。在这里，我们描述了一位中年妇女臀肌植入物相关 ALCL（GIA-ALCL）的独特病例。该患者在诊断为 GIA-ALCL 的一年前接受了双侧纹理硅胶臀肌植入物。随后，该患者因臀肌植入物部位溃疡而到我们机构的整形与重建外科就诊。不幸的是，在进行解释之前，她的病情恶化了。左肺肿块活检显示 ALCL 的“标志性”细胞（马蹄形核）。免疫组化检测证实了这一诊断，该检测显示异常细胞群表达 CD30、CD4、CD43、BCL6、穿孔素和 Ki67。因此，本病例报告的目的是证明所有接受纹理硅胶植入物植入的患者都有罹患 ALCL 的风险，并为可能的新诊断 GIA-ALCL 提供证据。证据等级：5 级。
