Should patients with suspected breast implant-associated anaplastic large cell lymphoma be tested for T-cell receptor gene rearrangement?
10.3760/cma.j.cn114453-20240205-00043
- VernacularTitle:怀疑乳房假体相关间变性大细胞淋巴瘤的患者是否应行T细胞受体基因重排检测？
- Author:
Yuxin LIU
1
;
Jiaming SUN
;
Jiajia LIU
;
Cen QIU
;
Junqi CUI
;
Danning ZHENG
;
Li YU
Author Information
1. 上海交通大学医学院附属第九人民医院整复外科，上海 200011
- Keywords:
Breast;
Breast implants;
Anaplastic large-cell lymphoma;
T-cell receptor gene rearrangement;
Seroma
- From:
Chinese Journal of Plastic Surgery
2024;40(5):514-519
- CountryChina
- Language:Chinese
-
Abstract:
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of T-cell lymphoma. Despite the scarcity of reported BIA-ALCL cases in Asia, it is imperative to research early diagnosis. The crucial diagnostic criteria for BIA-ALCL include the presence of ALK - and CD30 + T cells exceeding 10% in the delayed seroma fluid. Furthermore, laboratory tests, such as histological examination of capsulectomies and analysis of clonal T-cell receptor (TCR) gene rearrangements, serve as important auxiliary diagnostic indicators. This article reported the case of a 56-year-old female patient who underwent bilateral breast augmentation with implants over 20 years ago. She presented with hardness, enlargement, and mild discomfort in her left breast. She was admitted to Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine in January 2023. MRI suggested implant rupture. Therefore, bilateral implant removal surgery was performed on February 2, 2023. Pathological examination of the fluid within the capsule of the left implant revealed a small number of ALK - and CD30 + T cells, with monoclonality observed in TCRγ gene rearrangement, indicating early changes suggestive of BIA-ALCL. Long-term follow-up is needed. The authors suggest that patients suspected of BIA-ALCL should undergo TCR gene rearrangement testing in addition to cytological and immunological examinations, which can provide guidance for the diagnosis, treatment, and necessary long-term follow-up of these patients.
