Breast implant-associated EBV-positive diffuse large B-cell lymphoma: Two case reports and literature review

Pathol Res Pract. 2021 Oct;226:153589. doi: 10.1016/j.prp.2021.153589. Epub 2021 Aug 13.


Lymphomas associated with breast implants are mostly of the T-cell type. They are predominantly anaplastic lymphoma kinase-negative anaplastic large cell lymphoma (ALK-negative ALCL) characterized by CD30 positivity universally. Whilst the majority of primary breast lymphomas occurring in the absence of breast implants are of B-cell origin, there are few cases of implant-associated B-cell lymphomas reported to date in the literature, a subset of which are diffuse large B-cell lymphoma (DLBCL). Given the rarity of this entity, we describe two cases of breast implant-associated DLBCL. Both patients developed Epstein-Barr Virus (EBV)-positive large cell lymphoma of B-cell origin confined to the implant capsule with no evidence of systemic lymphoma. Considering the association with EBV, the activated B-cell phenotype and the presumed chronic inflammatory environment associated with the implant capsule, these might represent forms of DLBCL associated with chronic inflammation (DLBCL-CI) or fibrin-associated DLBCL (FA-DLBCL). Treatment included implant removal with total capsulectomy, and for one of the cases adjuvant systemic chemotherapy. Recognizing this rare type of breast implant-associated B-cell lymphoma could improve our understanding of this entity and hence develop appropriate management strategies.

Keywords: Breast implant B-cell lymphoma; DLBCL associated with chronic inflammation; Diffuse large B-cell lymphoma (DLBCL); EBV-positive breast implant lymphoma; Fibrin-associated DLBCL.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Breast Implants / adverse effects*
  • Breast Neoplasms / etiology*
  • Carcinoma, Lobular / pathology
  • Epstein-Barr Virus Infections / complications*
  • Female
  • Humans
  • Lymphoma, Large B-Cell, Diffuse / etiology*
  • Middle Aged
  • Neoplasms, Multiple Primary / pathology