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Breast Implant-associated ALCL

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Microscopic Features of Breast Implant-associated Anaplastic Large Cell Lymphoma (ALCL): The diagnosis is frequently made by cytological examination of the fluid aspirated from the seroma cavity (see slide 36). In capsulectomy specimens (as shown here), the tumor cells form sheets or aggregates in the fibrous pseudocapsule around the implant. In rare cases, the tumor cells may form a grossly palpable mass. The tumor cells are large and pleomorphic and resemble hallmark cells seen in other forms of ALCL. They have abundant cytoplasm, vesicular nuclei, and prominent nucleoli.

Differential Diagnosis: Breast implant-associated ALCL should be distinguished from carcinoma, primary effusion lymphoma, system ALK+ ALCL with breast involvement, diffuse large B-cell lymphoma, and plasma cell myeloma.

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