Clinicopathologic features and prognostic impact of lymph node involvement in patients with breast implant-associated anaplastic large cell lymphoma Journal Article


Authors: Ferrufino-Schmidt, M. C.; Medeiros, L. J.; Liu, H.; Clemens, M. W.; Hunt, K. K.; Laurent, C.; Lofts, J.; Amin, M. B.; Ming Chai, S.; Morine, A.; Di Napoli, A.; Dogan, A.; Parkash, V.; Bhagat, G.; Tritz, D.; Quesada, A. E.; Pina-Oviedo, S.; Hu, Q.; Garcia-Gomez, F. J.; Jose Borrero, J.; Horna, P.; Thakral, B.; Narbaitz, M.; Hughes, R. C. 3rd; Yang, L. J.; Fromm, J. R.; Wu, D.; Zhang, D.; Sohani, A. R.; Hunt, J.; Vadlamani, I. U.; Morgan, E. A.; Ferry, J. A.; Szigeti, R.; Tardio, J. C.; Granados, R.; Dertinger, S.; Offner, F. A.; Pircher, A.; Hosry, J.; Young, K. H.; Miranda, R. N.
Article Title: Clinicopathologic features and prognostic impact of lymph node involvement in patients with breast implant-associated anaplastic large cell lymphoma
Abstract: 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. © 2017 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: t-cell lymphoma; hodgkin lymphoma; anaplastic large cell lymphoma; lymph node involvement; breast implant; cd30; alcl
Journal Title: American Journal of Surgical Pathology
Volume: 42
Issue: 3
ISSN: 0147-5185
Publisher: Lippincott Williams & Wilkins  
Date Published: 2018-03-01
Start Page: 293
End Page: 305
Language: English
DOI: 10.1097/pas.0000000000000985
PROVIDER: scopus
PUBMED: 29194092
DOI/URL:
Notes: Article -- Export Date: 1 May 2018 -- Source: Scopus
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  1. Ahmet Dogan
    162 Dogan