Breast, Breast implant associated anaplastic large cell lymphoma [LMP15493]

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Diagnostic Modality: 
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Disease Category: 
Neoplasia
Diagnosis: 
Breast implant associated anaplastic large cell lymphoma
Species: 
Human
Organ System: 
Breast
Gender: 
Female
Age: 
79 years
Diagnosis Code: 
ICD-10: C84.5 | ICD-O: 9714/3
Slide Contributor Information
Shivji, S., Lu, F.

Keywords

breast cancer, lymphoma, anaplastic, large cell, breast implant, breast

Clinical History

79 year old female patient with a history of breast implantation, presenting for excision of the implant capsule.

Clinical Discussion

Primary large cell lymphoma of the breast is a rare entity, but has been reported in the literature, particularly in association with a prior history of breast implant. The classical clinical presentation is that of a sudden onset of edema, with some cases presenting as a mass lesion. Histologically, the key diagnostic feature is the presence of large, atypical lymphoid cells which may show mitotic activity. Given that the cells may only be focally present, a high index of suspicion along with clinical history is required in order to accurately make this diagnosis.

The classic immunophenotype for these lesions is that of a CD4+ and CD30+ large T cell lymphoma, which, in contrast to large T cell lymphomas at other anatomic sites, is usually ALK-negative; large B cell lymphomas, however, have also been described.

Primary large cell lymphoma typically has an indolent behavior with no systemic involvement. Treatment typically consists of removal of the breast implant, with or without adjuvant chemotherapy and/or radiation therapy.