Riecke Kerstin, Steinhilper Lisa, von Bülow Charlotte, Schwarz Dorothee, Burandt Eike, Striefler Jana Käthe, Müller Volkmar, Schmalfeldt Barbara, Witzel Isabell
Department of Gynaecology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Radiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Breast Care (Basel). 2024 Feb;19(1):73-76. doi: 10.1159/000534367. Epub 2023 Sep 30.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is still a rare extralymphatic lymphoma. As of March 1, 2023, approximately 1,355 cases of BIA-ALCL have been reported worldwide. However, no such case has yet been described with pectoral implants in male patients. Most patients with BIA-ALCL present with nonspecific implant-associated symptoms such as late-onset seroma, swollen breasts, and deformation of implants.
Here, we describe BIA-ALCL in a 76-year-old male patient who presented with a late-onset seroma in order to raise awareness for BIA-ALCL also in men after esthetic chest surgery with silicone pectoral implants. The patient had undergone augmentation of the pectoralis muscle with implants for esthetic reasons 9 years before. First cytological specimens showed no malignancy. A repeated cytological assessment after 6 weeks from recurring seroma showed characteristic CD30+ T-cell clones. Surgery with complete bilateral capsulectomy and implant removal was performed. Due to the early-stage ALCL being limited only to the capsule and no evidence of systemic disease, adjuvant systemic treatment was not considered necessary.
Any persisting late-onset seroma also in male patients with pectoral implants should raise suspicion of ALCL as differential diagnosis and should be assessed with cytological examination.
乳房植入物相关间变性大细胞淋巴瘤(BIA-ALCL)仍然是一种罕见的结外淋巴瘤。截至2023年3月1日,全球已报告约1355例BIA-ALCL病例。然而,尚未有男性患者使用胸肌植入物出现此类病例的描述。大多数BIA-ALCL患者表现为非特异性的植入物相关症状,如迟发性血清肿、乳房肿胀和植入物变形。
在此,我们描述了一名76岁男性患者的BIA-ALCL病例,该患者出现迟发性血清肿,目的是提高人们对硅胶胸肌植入物美容胸部手术后男性BIA-ALCL的认识。该患者9年前出于美容原因接受了植入物胸大肌增大术。首次细胞学标本未显示恶性肿瘤。复发性血清肿6周后重复进行的细胞学评估显示出特征性的CD30+T细胞克隆。进行了双侧完全包膜切除术和植入物取出手术。由于早期ALCL仅局限于包膜且无全身疾病证据,因此认为无需辅助全身治疗。
男性胸肌植入物患者出现任何持续的迟发性血清肿都应怀疑为ALCL并作为鉴别诊断,应通过细胞学检查进行评估。