Chiriac Radu, Donzel Marie, Baseggio Lucile
Laboratoire d'hématologie biologique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France.
Service d'anatomie pathologique, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Pierre-Bénite, France, Université Claude Bernard Lyon 1, Centre International de Recherche en Infectiologie INSERM U1111 - CNRS UMR5308, Team Lymphoma Immuno-Biology, Lyon, France.
Ann Biol Clin (Paris). 2025 Jun 20;83(3):303-309. doi: 10.1684/abc.2025.1976.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare T-cell non-Hodgkin lymphoma, representing less than 1% of breast neoplasms. Despite its low incidence, the increasing number of women with breast implants necessitates vigilance among clinicians and pathologists. BIA-ALCL presents in situ and invasive forms, with varying prognoses. The National Comprehensive Cancer Network guidelines recommend cytology, immunohistochemistry, and flow cytometry (FCM) for diagnosis. This retrospective study analyzed 16 periprosthetic fluid (PF) samples from suspected lymphoma cases between January 2018 and January 2024. Cytological and immunological analyses were performed using May Grünwald-Giemsa staining, and FCM with BD FACSCanto II and BD LYRIC cytometers. A 10 or 12-colour FCM panel including pan-T markers and CD30 was used. Of the 16 samples, 2 cases were diagnosed with BIA-ALCL. BIA-ALCL cases showed atypical CD4+ T-cells with large size and loss of CD3 and CD7. In contrast, the 14 reactive cases did not exhibit atypical cells. Key challenges included sample volume limitations, cell dilution, and distinguishing neoplastic cells from reactive ones, particularly in cases with low cell counts. FCM, combined with an extensive panel of pan-T markers and CD30, effectively differentiates anaplastic BIA-ALCL cells from reactive seroma. However, it should complement, not replace, traditional diagnostic methods. Recognizing pitfalls and correlating FCM findings with clinical and morphological data enhances diagnostic accuracy. FCM is a valuable tool for diagnosing BIA-ALCL but should be used alongside other methods. Accurate diagnosis depends on understanding sample-specific challenges and integrating FCM results with clinical context.
乳房植入物相关间变性大细胞淋巴瘤（BIA-ALCL）是一种罕见的T细胞非霍奇金淋巴瘤，占乳腺肿瘤的比例不到1%。尽管其发病率较低，但乳房植入物女性数量的增加使得临床医生和病理学家必须保持警惕。BIA-ALCL有原位和侵袭性两种形式，预后各不相同。美国国立综合癌症网络指南推荐采用细胞学、免疫组织化学和流式细胞术（FCM）进行诊断。这项回顾性研究分析了2018年1月至2024年1月期间16例疑似淋巴瘤病例的假体周围液（PF）样本。使用May Grünwald-Giemsa染色进行细胞学和免疫学分析，并使用BD FACSCanto II和BD LYRIC细胞仪进行FCM检测。使用包括泛T标志物和CD30的10色或12色FCM检测板。在这16个样本中，有2例被诊断为BIA-ALCL。BIA-ALCL病例显示出非典型的CD4+T细胞，细胞体积大，CD3和CD7缺失。相比之下，14例反应性病例未显示非典型细胞。主要挑战包括样本量限制、细胞稀释以及将肿瘤细胞与反应性细胞区分开来，尤其是在细胞计数较低的病例中。FCM结合广泛的泛T标志物和CD30检测板，可有效区分间变性BIA-ALCL细胞与反应性血清肿。然而，它应作为传统诊断方法的补充，而非替代。认识到陷阱并将FCM结果与临床和形态学数据相关联可提高诊断准确性。FCM是诊断BIA-ALCL的有价值工具，但应与其他方法一起使用。准确诊断取决于了解样本特异性挑战并将FCM结果与临床背景相结合。
