Flow cytometry of ALK-negative anaplastic large cell lymphoma of breast implant-associated effusion and capsular tissue

Cytometry B Clin Cytom. 2015 Jan;88(1):58-63. doi: 10.1002/cyto.b.21178. Epub 2014 Jul 11.


Background: Anaplastic large cell lymphoma (ALCL) of the breast capsule is a rare lymphoma involving capsular tissues and/or effusions associated with breast implants. While several studies have detailed the histological and immunohistochemical (IHC) features of these tumors, no study has yet described flow cytometry features of the neoplastic cells of this entity. Here, we report two cases from our institution in which multi-parametric flow cytometry was performed.

Methods: The immunophenotype of ALCL in association with breast implant was evaluated by flow cytometry.

Results: We show that much like CD30+ tumor cells of classical Hodgkin lymphoma (CHL) and ALCL of non-breast implant tumors, the neoplastic cells of this entity can be readily identified by flow cytometry. The neoplastic cells of both cases were largely devoid of T-cell antigens, but had expression of weak CD15, strong CD30, and expression of CD40. These results are correlated with routine morphologic and IHC analysis, supporting the flow cytometry immunophenotype.

Conclusions: Flow cytometry can aid in the diagnostic evaluation of effusions or tissue samples in association with breast implant/prostheses.

Keywords: anaplastic large cell lymphoma; breast capsule; breast implant associated lymphoma; flow cytometry.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anaplastic Lymphoma Kinase
  • Breast Implants / adverse effects*
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / etiology
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • CD40 Antigens / genetics
  • CD40 Antigens / metabolism
  • Female
  • Flow Cytometry
  • Gene Expression
  • Humans
  • Immunophenotyping
  • Ki-1 Antigen / genetics
  • Ki-1 Antigen / metabolism
  • Lewis X Antigen / genetics
  • Lewis X Antigen / metabolism
  • Lymphoma, Large-Cell, Anaplastic / diagnosis*
  • Lymphoma, Large-Cell, Anaplastic / etiology
  • Lymphoma, Large-Cell, Anaplastic / metabolism
  • Lymphoma, Large-Cell, Anaplastic / pathology
  • Middle Aged
  • Receptor Protein-Tyrosine Kinases / deficiency*
  • Receptor Protein-Tyrosine Kinases / genetics
  • T-Lymphocytes / metabolism
  • T-Lymphocytes / pathology*


  • CD40 Antigens
  • Ki-1 Antigen
  • Lewis X Antigen
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • Receptor Protein-Tyrosine Kinases