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以迟发性血清肿为表现的类肉瘤病,类似乳房植入物相关间变性大细胞淋巴瘤。

Sarcoidosis Presenting as Late Seroma Mimicking Breast Implant-Associated Anaplastic Large Cell Lymphoma.

机构信息

From the Department of Plastic and Reconstructive Surgery, Gregorio Maranon Hospital, Madrid, Spain.

出版信息

Ann Plast Surg. 2021 Oct 1;87(4):415-420. doi: 10.1097/SAP.0000000000002684.

Abstract

Late seroma related to breast silicone implants is a rare complication. Interest for its characterization has grown after its association with the recently described breast implant-associated anaplastic large cell lymphoma. The differential diagnosis includes infectious diseases, mechanical and traumatic causes, tumors, postpartum seroma, and inflammatory, allergic, or idiopathic causes.Sarcoidosis has been associated with breast silicone implants over the last decades, but it has never been reported as a cause of breast effusion. We describe a rare presentation of sarcoidosis as a late breast implant seroma simulating the clinical features and radiologic findings of breast implant-associated anaplastic large cell lymphoma and highlight that sarcoidosis can be suspected by the presence of nonnecrotizing epithelioid granulomas in the cytology, with a characteristic inverted ratio of CD4/CD8 T cells.The aims of this article are to review the current evidence about sarcoidosis related to silicone implants and breast cancer, provide a new alternative in the differential diagnosis of late seroma, and advise the scientific community how early implant removal can improve the disease.

摘要

晚期与乳房硅酮植入物相关的血清肿是一种罕见的并发症。在其与最近描述的乳房植入物相关间变性大细胞淋巴瘤相关联之后,人们对其特征的兴趣有所增加。鉴别诊断包括传染病、机械和创伤性原因、肿瘤、产后血清肿以及炎症、过敏或特发性原因。在过去几十年中,类肉瘤已与乳房硅酮植入物相关联,但从未有报道称其为乳房积液的原因。我们描述了一种罕见的类肉瘤表现为晚期乳房植入物血清肿,模拟了乳房植入物相关间变性大细胞淋巴瘤的临床特征和影像学发现,并强调类肉瘤可以通过细胞学中非坏死性上皮样肉芽肿的存在来怀疑,其具有特征性的 CD4/CD8 T 细胞倒置比例。本文的目的是回顾与硅酮植入物和乳腺癌相关的类肉瘤的现有证据,为晚期血清肿的鉴别诊断提供新的选择,并建议科学界如何通过早期移除植入物来改善疾病。

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