PDF(Pubmed)
Abstract：
Breast Implant-Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare T-cell non-Hodgkin lymphoma associated with breast prosthetic implants and represents a diagnostic challenge. The National Comprehensive Cancer Network (NCCN) guidelines, updated in 2024, recommend for diagnosis an integrated work-up that should include cell morphology, CD30 immunohistochemistry (IHC), and flow cytometry (FCM). CD30 IHC, although the test of choice for BIA-ALCL diagnosis, is not pathognomonic, and this supports the recommendation to apply a multidisciplinary approach. A close collaboration between pathologists and laboratory professionals allowed the diagnosis of three BIA-ALCLs, presented as case reports, within a series of 35 patients subjected to periprosthetic effusions aspiration from 2018 to 2023. In one case, rare neoplastic cells were identified by FCM, and this result was essential in leading the anatomopathological picture as indicative of this neoplasm. In fact, the distinction between a lymphomatous infiltrate from reactive cells may be very complex in the cytopathology and IHC setting when neoplastic cells are rare. On the other hand, one limitation of FCM analysis is the need for fresh samples. In this study, we provide evidence that a dedicated fixative allows the maintenance of an unaltered CD30 expression on the cell surface for up to 72 h.
摘要：
乳房植入物相关的间变性大细胞淋巴瘤（BIA-ALCL）是与乳房假体植入物相关的罕见T细胞非霍奇金淋巴瘤，是诊断挑战。国家综合癌症网络（NCCN）指南2024年更新，建议进行诊断，包括细胞形态学的综合检查，CD30免疫组织化学（IHC），和流式细胞术（FCM）。CD30IHC,虽然BIA-ALCL诊断的首选测试，不是pathognomonic，这支持采用多学科方法的建议。病理学家和实验室专业人员之间的密切合作允许诊断三个BIA-ALCL，作为病例报告呈现，在2018年至2023年接受假体周围积液抽吸的35例患者中。在一个案例中,通过FCM鉴定出罕见的肿瘤细胞，这个结果对于引导解剖病理学图片作为这种肿瘤的指示是必不可少的。事实上,在肿瘤细胞很少见的情况下,在细胞病理学和IHC设置中,淋巴瘤浸润与反应性细胞之间的区别可能非常复杂.另一方面,FCM分析的一个局限性是需要新鲜样品。在这项研究中,我们提供的证据表明，专用的固定剂可以使细胞表面的CD30表达保持不变长达72小时。
