Anaplastic large cell lymphoma involving the breast: a clinicopathologic study of 6 cases and review of the literature.
BACKGROUND
Lymphomas involving the breast are rare, and most cases are of B-cell lineage; T-cell neoplasms represent less than 10% of all breast lymphomas.


OBJECTIVE
To define the clinicopathologic spectrum of anaplastic large cell lymphomas (ALCLs) involving the breast.


METHODS
Six cases of ALCL involving the breast were identified at a single institution during 21 years. The clinicopathologic and immunophenotypic features are presented, and the literature is reviewed.


RESULTS
All patients were women, with a median age of 52 years. There were 4 anaplastic lymphoma kinase- negative (ALK(-)) ALCL cases; 3 of these neoplasms developed around breast implants. Two patients with ALK(-) ALCL had a history of cutaneous ALCL. There were 2 ALK(+) ALCLs; both patients had stage IV disease. Histologically, all neoplasms were composed of large anaplastic cells that were uniformly CD30(+) and expressed markers of T-cell lineage. Four patients with adequate follow-up are alive, with a mean of 4.1 years (range, 1.5-9 years) after diagnosis of the breast tumor. Included in this group are 2 patients with ALK(-) ALCL associated with breast implants who were alive 4 years and 9 years after diagnosis.


CONCLUSIONS
Including the 6 cases we describe, a total of 21 cases of ALCL involving the breast are reported. Fifteen cases, all ALK(-), were associated with breast implants, suggesting a possible pathogenetic relationship, and associated with an excellent prognosis. Patients with cutaneous ALCL can subsequently develop ALK(-) ALCL involving the breast, and these tumors can be associated with breast implants.
Miranda
Roberto N
RN
Department of Hematopathology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. roberto.miranda@mdanderson.org
Lin
Lin
L
Talwalkar
Sameer S
SS
Manning
John T
JT
Medeiros
L Jeffrey
LJ
D000328:Adult; D000368:Aged; D000077548:Anaplastic Lymphoma Kinase; D014408:Biomarkers, Tumor / Q000378:metabolism; D019928:Breast Implantation; D001943:Breast Neoplasms / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D003131:Combined Modality Therapy; D004273:DNA, Neoplasm / Q000032:analysis; D017809:Fatal Outcome; D005260:Female; D015334:Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor / Q000235:genetics; D006801:Humans; D017730:Ki-1 Antigen / Q000378:metabolism; D017728:Lymphoma, Large-Cell, Anaplastic / Q000235:genetics / Q000378:metabolism / Q000473:pathology*; D008875:Middle Aged; D011505:Protein-Tyrosine Kinases / Q000378:metabolism; D020794:Receptor Protein-Tyrosine Kinases; D055815:Young Adult
D014408:Biomarkers, Tumor; D004273:DNA, Neoplasm; D017730:Ki-1 Antigen; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D011505:Protein-Tyrosine Kinases; D020794:Receptor Protein-Tyrosine Kinases