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乳房植入物相关间变性大细胞淋巴瘤病例报告:诊断、治疗及乳房重建

A case report of BIA-ALCL: Diagnostic, treatment, and mammary reconstruction.

作者信息

González Alan A, Ortega-Muñoz Laura, Quibano-Ordoñez Daniela, Puello Sergio, Vélez-Varela Patricia E, Moreno Pedro A

机构信息

CareMe 360 Institute S.A.S. Barranquilla, Colombia.

Integrim S.A.S., Bogotá DC, Colombia.

出版信息

Int J Surg Case Rep. 2024 Sep;122:110086. doi: 10.1016/j.ijscr.2024.110086. Epub 2024 Jul 27.

Abstract

INTRODUCTION AND IMPORTANCE

BIA-ALCL is a non-Hodgkin lymphoma occurring primarily in women with textured breast implants, typically presenting as late seroma. Diagnosis involves ultrasound-guided fine-needle aspiration or core needle biopsy, followed by cytologic and immunohistochemical evaluation. Positive results show CD30 cell expression and lack ALK expression. Treatment includes removing breast implants and the periprosthetic capsule. If the lymphoma has spread, en bloc capsulectomy, immunotherapy, and chemotherapy are required. Reconstruction can be done with smooth implants or autologous tissue.

PRESENTATION OF CASE

We present here the case of a woman with a 12-year history of microtextured breast implants, without any cancer family background, who presented with peri-implant effusion in the left breast, which tested positive for BIA-ALCL at stage IA. The patient underwent breast implant removal with total capsulectomy and posterior successful autologous tissue reconstruction, demonstrating that outcomes can be satisfactory when properly treated.

CLINICAL DISCUSSION

Paying attention to signs in women with breast implants, beyond imaging tests, can aid in the early diagnosis of BIA-ALCL and ensure a not aggressive treatment. This approach allows the reconstruction with autologous tissue without the need of further implants.

CONCLUSION

BIA-ALCL is a rare disease, further studies about this lymphoma can help with early diagnosis and potential prevention.

摘要

引言与重要性

乳房植入物相关间变性大细胞淋巴瘤(BIA-ALCL)是一种主要发生于使用带纹理乳房植入物女性的非霍奇金淋巴瘤,通常表现为迟发性血清肿。诊断包括超声引导下细针穿刺抽吸或粗针活检,随后进行细胞学和免疫组织化学评估。阳性结果显示CD30细胞表达且缺乏ALK表达。治疗包括取出乳房植入物和假体周围包膜。如果淋巴瘤已扩散,则需要进行整块包膜切除术、免疫治疗和化疗。可使用光滑的植入物或自体组织进行重建。

病例介绍

我们在此呈现一例有12年微纹理乳房植入物病史、无任何癌症家族背景的女性病例,该患者左乳房出现植入物周围积液,IA期BIA-ALCL检测呈阳性。患者接受了乳房植入物取出及全包膜切除术,随后成功进行了自体组织重建,表明经适当治疗,结果可能令人满意。

临床讨论

除了影像学检查外,关注有乳房植入物女性的体征有助于BIA-ALCL的早期诊断,并确保采取非激进的治疗方法。这种方法允许使用自体组织进行重建,而无需进一步植入物。

结论

BIA-ALCL是一种罕见疾病,对这种淋巴瘤的进一步研究有助于早期诊断和潜在预防。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8660/11342873/18cc26a32efb/gr1.jpg

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