Alotaibi Shaikha, Hamadani Mehdi, Al-Mansour Mubarak, Aljurf Mahmoud
Oncology Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia.
Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.
Clin Lymphoma Myeloma Leuk. 2021 Mar;21(3):e272-e276. doi: 10.1016/j.clml.2020.12.005. Epub 2020 Dec 13.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon lymphoproliferative disorder, mainly associated with textured implants. The average time from the breast implants to the development of BIA-ALCL is about 7 to 10 years, and the median age at the time of diagnosis is in the mid-50s. The exact incidence and prevalence of BIA-ALCL are not known. The pathogenesis of BIA-ALCL remains unclear. Different theories have been postulated, including immune response to textured implants, subclinical bacterial infection, and genetic predisposition. However, none of those theories have yet been proven to be causal in the pathogenesis of BIA-ALCL. BIA-ALCL is histologically similar to but clinically distinct from other CD30-positive T-cell lymphomas such as anaplastic lymphoma kinase-positive, anaplastic lymphoma kinase-negative, and primary cutaneous ALCL. The revised World Health Organization classification of lymphoid neoplasm in 2016 recognized BIA-ALCL as a provisional entity. Suspected cases need proper evaluation and workup to confirm the diagnosis. Surgical resection should be considered for all the cases. However, adjuvant radiotherapy and anthracycline-based chemotherapy are warranted for locally advanced and advanced cases.
乳房植入物相关间变性大细胞淋巴瘤(BIA-ALCL)是一种罕见的淋巴增殖性疾病,主要与带纹理的植入物有关。从植入乳房植入物到发生BIA-ALCL的平均时间约为7至10年,诊断时的中位年龄在50多岁。BIA-ALCL的确切发病率和患病率尚不清楚。BIA-ALCL的发病机制仍不清楚。已经提出了不同的理论,包括对带纹理植入物的免疫反应、亚临床细菌感染和遗传易感性。然而,这些理论均未被证实在BIA-ALCL的发病机制中具有因果关系。BIA-ALCL在组织学上与其他CD30阳性T细胞淋巴瘤相似,但在临床上有所不同,如间变性淋巴瘤激酶阳性、间变性淋巴瘤激酶阴性和原发性皮肤ALCL。2016年世界卫生组织修订的淋巴肿瘤分类将BIA-ALCL确认为一个临时实体。疑似病例需要进行适当的评估和检查以确诊。所有病例均应考虑手术切除。然而,对于局部晚期和晚期病例,辅助放疗和基于蒽环类药物的化疗是必要的。