title: ALK-1-negative anaplastic large cell lymphoma associated with breast implants: a new clinical entity.
abstract: Concerns have been raised recently regarding the increasing number of reports of non-Hodgkin lymphoma (NHL) that developed in close proximity to silicone or saline breast implants. In particular, an increased risk of anaplastic large cell lymphoma (ALCL) in patients with breast prostheses has been proposed. We reviewed clinical and pathologic findings in 40 women who received a diagnosis of breast NHL arising in association with breast implants and of 27 patients who had a diagnosis of ALCL with breast involvement reported in the published literature. Among the 40 reported cases of prosthesis-associated breast lymphomas, 28 were anaplastic lymphoma kinase-1-negative (ALK-1(-)) ALCLs, whereas of 27 ALCLs in patients without implants found in the literature, only 10 were ALK-1(-). The finding of 28 cases of breast ALK-1(-) ALCL occurring in patients with implants compared with 10 cases in women without implants is in favor of an association between silicone breast prostheses and ALK-1(-) ALCL. Although the incidence of this type of lymphoma remains remarkably low given that breast prostheses have been widely used for decades, clinical and pathologic evidence for a causative role is becoming dramatically strong. The histologic, phenomenologic, and clinical similarities of the majority of implant-related ALK-1(-) ALCLs suggest a common mechanism, especially when compared with the counterpart of patients without implants in which very few and highly dishomogeneous cases of the same malignancy were detected. There is convincing evidence that primary implant-related ALK-1(-) ALCL represents a distinct clinicopathologic entity that has been inappropriately fitted into the category of systemic ALK-1(-) ALCL. Thus it should be recognized as a separate category and classified on its own.
authors: Plastic and Reconstructive Surgery Unit, Hospital of Pisa, Italy. davidelazzeri@gmail.com
authors: Davide
authors: D
authors: Lazzeri
authors: Tommaso
authors: T
authors: Agostini
authors: Guido
authors: G
authors: Bocci
authors: Giordano
authors: G
authors: Giannotti
authors: Giovanni
authors: G
authors: Fanelli
authors: Antonio Giuseppe
authors: AG
authors: Naccarato
authors: Romano
authors: R
authors: Danesi
authors: Marco
authors: M
authors: Tuccori
authors: Marcello
authors: M
authors: Pantaloni
authors: Carlo
authors: C
authors: D'Aniello
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000077548:Anaplastic Lymphoma Kinase; D018427:Breast Implants / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000139:chemically induced* / Q000378:metabolism; D005260:Female; D006801:Humans; D017728:Lymphoma, Large-Cell, Anaplastic / Q000139:chemically induced* / Q000378:metabolism; D008875:Middle Aged; D020794:Receptor Protein-Tyrosine Kinases; D012189:Retrospective Studies; D012828:Silicones; D012965:Sodium Chloride
chemical_list: D012828:Silicones; D012965:Sodium Chloride; C000626173:ALK protein, human; D000077548:Anaplastic Lymphoma Kinase; D020794:Receptor Protein-Tyrosine Kinases