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Breast Implant-associated ALCL

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Introduction: This variant of anaplastic large cell lymphoma (ALCL) is morphologically and immunophenotypically identical to ALK-negative ALCL and is associated with breast implants. It is extremely rare with an incidence of 1 case per 500,000 to 3 million women with implants. It is distinct from cases of systemic ALK-positive ALCL with breast involvement.

Clinical Features: The mean age at diagnosis is 50 years. The mean interval from implant placement to the development of lymphoma is around 11 years. The type of implant (silicone vs. saline; smooth vs. textured) or previous history of breast cancer do not have a role.

Patients usually present with peri-implant effusion or a localized seroma. A discrete mass is seen only rarely. About 30% of cases have axillary lymph node involvement. Most cases present with stage I disease. Rarely, the disease is disseminated at presentation.

About this image: This low magnification view shows clusters of neoplastic cells on the inner aspect (irregular right edge) of the fibrous pseudocapsule surrounding the breast implant. Chronic inflammatory cells are scattered throughout the fibrous tissue of the pseudocapsule.

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