Axillary Lymphadenopathy: An Outstanding Presentation for Breast Implant-Associated ALK-Negative Anaplastic Large Cell Lymphoma

Int J Surg Pathol. 2015 Aug;23(5):424-8. doi: 10.1177/1066896915579103. Epub 2015 Mar 31.

Abstract

Till date, there is only one reported case of breast implant-associated ALK-negative anaplastic large cell lymphoma (ALCL) with an axillary presentation that followed an aggressive behavior. We report the case of a 50-year-old female presenting with an axillary lymphadenopathy 8 years after breast prostheses implantation. Clinical examination, ultrasound, and magnetic resonance imaging detected no mammary lesions. The lymph node showed intrasinusoidal infiltration by large pleomorphic cells expressing CD30 and lacking ALK-immunoreactivity. Tumor staging was negative. Cells with identical features were found in the ipsilateral periprosthetic capsule. The patient was treated with CHOP and radiotherapy, and she is alive without evidence of disease after a 30-month follow-up. The diagnosis of an ALK-negative ALCL in an axillary lymph node of a patient with ipsilateral breast prosthesis and negative staging should prompt removal of the implant with capsulectomy, since the pathological study of this specimen allows the correct diagnosis with important prognostic implications.

Keywords: ALK-negative anaplastic large cell lymphoma; breast implant–associated anaplastic large cell lymphoma; breast lymphoma; silicone gel prosthesis.

Publication types

  • Case Reports

MeSH terms

  • Anaplastic Lymphoma Kinase
  • Axilla
  • Biomarkers, Tumor / metabolism*
  • Breast Implantation*
  • Female
  • Humans
  • Lymph Nodes / pathology*
  • Lymphoma, Large-Cell, Anaplastic / etiology*
  • Lymphoma, Large-Cell, Anaplastic / metabolism
  • Lymphoma, Large-Cell, Anaplastic / pathology
  • Middle Aged
  • Postoperative Complications / metabolism
  • Postoperative Complications / pathology*
  • Receptor Protein-Tyrosine Kinases / metabolism*

Substances

  • Biomarkers, Tumor
  • ALK protein, human
  • Anaplastic Lymphoma Kinase
  • Receptor Protein-Tyrosine Kinases