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乳腺植入物相关间变性大细胞淋巴瘤的当前认识

Current Understanding of Breast Implant-Associated Anaplastic Large Cell Lymphoma.

作者信息

Bewtra Chehak, Gharde Pankaj

机构信息

Department of Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND.

出版信息

Cureus. 2022 Oct 20;14(10):e30516. doi: 10.7759/cureus.30516. eCollection 2022 Oct.

DOI:10.7759/cureus.30516
PMID:36420249
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9678239/
Abstract

Every year, breast implants are inserted worldwide for reconstructive or aesthetic reasons. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rather uncommon type of T cell lymphoma that is positive for the CD30 biomarker. Despite being far more common than other primary breast lymphomas, BIA-ALCL has a very low incidence. Textured types of implants have been linked to almost all cases. The majority of patients have a favorable prognosis after the removal of implants and capsules. Nevertheless, the chance of a fatal outcome is higher with capsular invasion and tumor bulk. Although the exact cause of BIA-ALCL is unknown, it has been suggested that persistent infections or toxins related to the implants may play a role. Therefore, physicians must be aware of breast implants' rare but potentially significant side effects. Before surgery, patients with verified instances should be directed to a breast medical oncologist or lymphoma specialist for oncologic assessment. Total en-bloc capsulectomy, a surgical procedure that removes the implant and the surrounding capsule, is usually adequate. In other cases, a late diagnosis necessitates more invasive surgery and systemic therapies, which, while typically effective, have been linked to poor outcomes and even fatalities. Since it is a recently described entity and the "denominator" (i.e., the total number of breast implant procedures) is unknown, it is challenging to determine the risk of development. In this review, we hope to emphasize the elements of etiology, demography, clinical features, and current treatment approaches for BIA-ALCL. In doing so, we hope to increase the medical professional's knowledge of the recognition and treatment of BIA-ALCL.

摘要

每年,世界各地都有人出于重建或美容目的植入乳房假体。乳房植入物相关间变性大细胞淋巴瘤(BIA-ALCL)是一种相当罕见的T细胞淋巴瘤,对CD30生物标志物呈阳性。尽管BIA-ALCL比其他原发性乳腺淋巴瘤更为常见,但其发病率非常低。几乎所有病例都与有纹理的假体类型有关。大多数患者在切除假体和包膜后预后良好。然而,出现包膜侵犯和肿瘤体积较大时,发生致命后果的几率更高。虽然BIA-ALCL的确切病因尚不清楚,但有人认为与假体相关的持续性感染或毒素可能起了作用。因此,医生必须意识到乳房假体罕见但可能具有重大意义的副作用。手术前,确诊病例的患者应转诊至乳腺肿瘤内科医生或淋巴瘤专科医生处进行肿瘤学评估。整块包膜切除术,即一种切除假体及周围包膜的外科手术,通常就足够了。在其他情况下,晚期诊断需要更具侵入性的手术和全身治疗,这些治疗虽然通常有效,但却与不良后果甚至死亡有关。由于这是一个最近才被描述的实体,而且“分母”(即乳房假体植入手术的总数)未知,因此确定其发生风险具有挑战性。在这篇综述中,我们希望强调BIA-ALCL的病因、人口统计学、临床特征和当前治疗方法等要素。通过这样做,我们希望增加医学专业人员对BIA-ALCL的识别和治疗的了解。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e71e/9678239/49dd3e116ea6/cureus-0014-00000030516-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e71e/9678239/49dd3e116ea6/cureus-0014-00000030516-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e71e/9678239/49dd3e116ea6/cureus-0014-00000030516-i01.jpg

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