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# Breast implant-associated anaplastic large cell lymphoma

Lucile Baseggio, Alexandra Travers-Glehen, Emmanuel Bachy, Camille

Laurent

► To cite this version:

Lucile Baseggio, Alexandra Travers-Glehen, Emmanuel Bachy, Camille Laurent. Breast implant-associated anaplastic large cell lymphoma. Blood research, 2019, 54 (1), pp.3. 10.5045/br.2019.54.1.3. inserm-04798366

HAL Id: inserm-04798366

https://inserm.hal.science/inserm-04798366v1

Submitted on 22 Nov 2024

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Distributed under a Creative Commons Attribution 4.0 International License
# Breast implant-associated anaplastic large cell lymphoma

Lucile Baseggio¹, Alexandra Travers-Glehen², Emmanuel Bachy³, Camille Laurent⁴

¹Laboratoire d'Hématologie Biologique, ²Service d'Anatomie Pathologique, ³Service d'Hématologie Clinique, Groupement Hospitalier Lyon-Sud/Hospices Civils de Lyon, Lyon, ⁴Service d'Anatomie Pathologique, Institut Universitaire du Cancer de Toulouse-Oncopole, Toulouse, France

Received on August 8, 2018; Revised on September 14, 2018; Accepted on September 18, 2018

**Correspondence to** Lucile Baseggio, Ph.D., Laboratoire d'Hématologie Biologique, Groupement Hospitalier Lyon-Sud/Hospices Civils de Lyon, 69002

Lyon, France, E-mail: lucile.baseggio@chu-lyon.fr

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A 73-year-old woman with bilateral breast implants following mastectomies for cancer and a previous right-sided implant revision due to implant rupture presented to us with ultrasound-confirmed fluid accumulation around the left implant, without lymphadenopathy, splenomegaly, or B symptoms.

Cytological analysis of the seroma fluid (A, cytocentrifuge preparation; MGG stain, ×100) showed medium to large cells with anaplastic morphology, basophilic cytoplasm, round to more irregular nuclei, and clumped or dispersed chromatin with rare small nuclei. Cytoblock immunohistochemistry (IHC) stained negative for ALK and positive for CD3, CD30, and TIA-1 (B, C). Flow cytometry (FCM) immunophenotyping of the fluid identified large CD4+ T-cells with aberrant phenotype (failed CD3/CD7 and partial CD5 expression); CD30 and HLA-DR were strongly expressed, as well as cytoplasmic cytotoxic markers TIA1, granzyme B, and perforin [D, lymphoma T-cells (purple), residual T-cells (blue)]. Cellular morphology and immunologic profile pointed to a diagnosis of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

BIA-ALCL, recently recognized in the 2016 World Health Organization Classification of Lymphomas, is often curable when diagnosed early. As recommended by the National Comprehensive Cancer Network (NCCN) guidelines, appropriate cytological examination of seroma fluid utilizing FCM and IHC, including CD30 and ALK staining, appears crucial to its diagnosis.

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