Maglic Dino, Moss Whitney, Pires Giovanna, Agarwal Archana, Matsen Cindy, Kwok Alvin
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, Utah.
Division of Pathology University of Utah School of Medicine, Salt Lake City, Utah.
Plast Reconstr Surg Glob Open. 2021 Nov 4;9(11):e3916. doi: 10.1097/GOX.0000000000003916. eCollection 2021 Nov.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare peripheral T-cell lymphoma associated with textured implants and usually presents as a late-onset periprosthetic seroma. We present a 70-year-old woman with a history of left breast invasive ductal carcinoma treated with mastectomy and textured implant-based reconstruction, and subsequent adjuvant chemotherapy due to lymphovascular extension. Eleven years following her reconstruction, the patient developed a periprosthetic seroma. Fine needle aspiration and partial capsulectomy were performed, but appropriate pathologic evaluation was not initially submitted. She then presented with lymphadenopathy, which was biopsied and revealed BIA-ALCL within an axillary lymph node. Despite implant explantation, complete capsulectomy, axillary lymph node dissection, and excision of groin lymphadenopathy, no evidence of primary ALCL was appreciated. This initially misdiagnosed case demonstrates the importance of following the National Comprehensive Cancer Network guidelines when a patient presents with late onset breast periprosthetic effusions.
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，与有纹理的植入物相关，通常表现为迟发性假体周围血清肿。我们报告一名70岁女性，有左乳浸润性导管癌病史，接受了乳房切除术和基于有纹理植入物的重建手术，随后因淋巴管侵犯接受了辅助化疗。重建术后11年，患者出现假体周围血清肿。进行了细针穿刺抽吸和部分囊切除术，但最初未提交适当的病理评估。随后她出现淋巴结病，对其进行活检，在腋窝淋巴结中发现了BIA-ALCL。尽管进行了植入物取出、完整囊切除术、腋窝淋巴结清扫和腹股沟淋巴结病切除，但未发现原发性ALCL的证据。这个最初误诊的病例表明，当患者出现迟发性乳房假体周围积液时，遵循美国国立综合癌症网络指南的重要性。
