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Title: Clinicopathologic Features and Prognostic Impact of Lymph Node Involvement in Patients With Breast Implant-associated Anaplastic Large Cell Lymphoma.
Authors: Ferrufino-Schmidt, Maria C
Medeiros, L Jeffrey
Liu, Hui
Clemens, Mark W
Hunt, Kelly K
Laurent, Camille
Lofts, Julian
Amin, Mitual B
Ming Chai, Siaw
Morine, Angela
Di Napoli, Arianna
Dogan, Ahmet
Parkash, Vinita
Bhagat, Govind
Tritz, Denise
Quesada, Andres E
Pina-Oviedo, Sergio
Hu, Qinlong
Garcia-Gomez, Francisco J
Jose Borrero, Juan
Horna, Pedro
Thakral, Beenu
Narbaitz, Marina
Hughes, R Condon
Yang, Li-Jun
Fromm, Jonathan R
Wu, David
Zhang, Da
Sohani, Aliyah R
Hunt, John
Vadlamani, Indira U
Morgan, Elizabeth A
Ferry, Judith A
Szigeti, Reka
C Tardio, Juan
Granados, Rosario
Dertinger, Susanne
Offner, Felix A
Pircher, Andreas
Hosry, Jeff
Young, Ken H
Miranda, Roberto N
metadata.dc.subject.mesh: Adult
Aged, 80 and over
Breast Implantation
Breast Implants
Breast Neoplasms
Diagnostic Errors
Hodgkin Disease
Lymph Nodes
Lymphoma, Large-Cell, Anaplastic
Middle Aged
Predictive Value of Tests
Treatment Outcome
Issue Date: 2018
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.
metadata.dc.identifier.doi: 10.1097/PAS.0000000000000985
Appears in Collections:Producción 2020

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