title: CD30+ T Cells in Late Seroma May Not Be Diagnostic of Breast Implant-Associated Anaplastic Large Cell Lymphoma.
abstract: The objective was to analyze and discuss the implications of a nonmalignant CD30+ late seroma. Methods included collection of seroma fluid and peripheral blood from a patient with a late seroma 22 years after initial breast reconstruction. A panel of 24 monoclonal antibodies was used to detect T-cell receptor Vβ regions present on ~70% of normal human peripheral blood T lymphocytes. Flow cytometry gated on CD3+ and CD30+ activated T lymphocytes. Cytospins were used to inspect the morphology of the T lymphocytes. Results from the seroma fluid cytology revealed a spectrum of activated T lymphocytes as seen in the blood of patients with immune disorders such as infectious mononucleosis. Cells were judged to be nonmalignant by routine pathology. Flow cytometry revealed >23% of CD3+ T lymphocytes belonged to an expanded T-cell family expressing TCRVβ13.2. Most Vβ13.2 cells expressed T-cell activation antigen CD30 indicating that CD30 is not restricted to anaplastic large cell lymphoma (ALCL) in seroma fluids. A smaller expanded population of CD30+ T lymphocytes expressing TCRVβ 13.2 was detected in the blood. In conclusion, in this index case, an expanded population of CD30+ activated T lymphocytes was detected in seroma fluid surrounding a textured breast implant as well as in peripheral blood, consistent with a local and systemic immune response. The demonstration of an expanded CD30+ T-cell population in a polyclonal background suggests a possible role for bacterial superantigens as a pathogenic factor. These data further suggest that breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) may be the end stage of a CD30+ T-cell lymphoproliferative disorder.
  
  
  
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authors.affiliation: Boston University School of Medicine, Boston, MA.|Roger Williams Medical Center, Providence, RI.
authors.forename: Marshall E
authors.initials: ME
authors.lastname: Kadin
authors.affiliation: Research Core Facility, Roger Williams Medical Center, Providence, RI.
authors.forename: John
authors.initials: J
authors.lastname: Morgan
authors.affiliation: Roger Williams Medical Center, Providence, RI.
authors.forename: Haiying
authors.initials: H
authors.lastname: Xu
authors.affiliation: Jersey Shore University Medical Center, Neptune, NJ.
authors.forename: Caroline A
authors.initials: CA
authors.lastname: Glicksman
mesh_terms: D000368:Aged; D018441:Biofilms; D019928:Breast Implantation / Q000009:adverse effects*; D018427:Breast Implants / Q000009:adverse effects* / Q000382:microbiology; D001943:Breast Neoplasms / Q000601:surgery*; D061765:Endoscopic Ultrasound-Guided Fine Needle Aspiration; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D017730:Ki-1 Antigen / Q000378:metabolism*; D017728:Lymphoma, Large-Cell, Anaplastic / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D049291:Seroma / Q000097:blood / Q000276:immunology / Q000473:pathology*; D013601:T-Lymphocytes / Q000276:immunology / Q000378:metabolism*; D013997:Time Factors
chemical_list: D017730:Ki-1 Antigen