Clinicopathologic Features and Prognostic Impact of Lymph Node Involvement in Patients With Breast Implant-associated Anaplastic Large Cell Lymphoma.

Journal Article (Journal Article)

Breast implant-associated anaplastic large cell lymphoma (BI-ALCL) is a rare T-cell lymphoma that arises around breast implants. Most patients manifest with periprosthetic effusion, whereas a subset of patients develops a tumor mass or lymph node involvement (LNI). The aim of this study is to describe the pathologic features of lymph nodes from patients with BI-ALCL and assess the prognostic impact of LNI. Clinical findings and histopathologic features of lymph nodes were assessed in 70 patients with BI-ALCL. LNI was defined by the histologic demonstration of ALCL in lymph nodes. Fourteen (20%) patients with BI-ALCL had LNI, all lymph nodes involved were regional, the most frequent were axillary (93%). The pattern of involvement was sinusoidal in 13 (92.9%) cases, often associated with perifollicular, interfollicular, and diffuse patterns. Two cases had Hodgkin-like patterns. The 5-year overall survival was 75% for patients with LNI and 97.9% for patients without LNI at presentation (P=0.003). Six of 49 (12.2%) of patients with tumor confined by the capsule had LNI, compared with LNI in 8/21 (38%) patients with tumor beyond the capsule. Most patients with LNI achieved complete remission after various therapeutic approaches. Two of 14 (14.3%) patients with LNI died of disease compared with 0/56 (0%) patients without LNI. Twenty percent of patients with BI-ALCL had LNI by lymphoma, most often in a sinusoidal pattern. We conclude that BI-ALCL beyond capsule is associated with a higher risk of LNI. Involvement of lymph nodes was associated with decreased overall survival. Misdiagnosis as Hodgkin lymphoma is a pitfall.

Full Text

Duke Authors

Cited Authors

  • Ferrufino-Schmidt, MC; Medeiros, LJ; Liu, H; Clemens, MW; Hunt, KK; Laurent, C; Lofts, J; Amin, MB; Ming Chai, S; Morine, A; Di Napoli, A; Dogan, A; Parkash, V; Bhagat, G; Tritz, D; Quesada, AE; Pina-Oviedo, S; Hu, Q; Garcia-Gomez, FJ; Jose Borrero, J; Horna, P; Thakral, B; Narbaitz, M; Hughes, RC; Yang, L-J; Fromm, JR; Wu, D; Zhang, D; Sohani, AR; Hunt, J; Vadlamani, IU; Morgan, EA; Ferry, JA; Szigeti, R; C Tardio, J; Granados, R; Dertinger, S; Offner, FA; Pircher, A; Hosry, J; Young, KH; Miranda, RN

Published Date

  • March 2018

Published In

Volume / Issue

  • 42 / 3

Start / End Page

  • 293 - 305

PubMed ID

  • 29194092

Pubmed Central ID

  • PMC7500854

Electronic International Standard Serial Number (EISSN)

  • 1532-0979

Digital Object Identifier (DOI)

  • 10.1097/PAS.0000000000000985

Language

  • eng

Conference Location

  • United States