目的:与乳房植入物相关的淋巴瘤主要是T细胞型,通常表现为植入物附近的迟发性血清肿或可触及的肿块。乳腺原发性淋巴瘤,在没有乳房植入物的情况下,大部分是B细胞型的.然而,我们介绍了1例Epstein-Barr病毒阳性的弥漫性大B细胞淋巴瘤患者的聚氨酯纹理植入物。
方法:一名75岁的女性患者出现右乳房突然肿胀。她的病史显示,在48岁时因左乳浸润性导管腺癌而进行了单侧乳房切除术。使用双侧McGhan型150植入物进行重建。九年后,她被诊断为Baker四型包膜挛缩和双侧破裂,如磁共振成像所见。更换植入物的完整囊切除术(Polytech,Replicon®SLHP)和右侧的乳房固定术。鉴于她的病史和突然出现的肿胀,情况令人担忧。超声显示与植入物接触的大肿块和周围的积液。切除乳房外植术和包囊切除术后,她被诊断为包膜的Epstein-Barr病毒相关性弥漫性大B细胞淋巴瘤(DLBCL),并伴有纹理化乳房植入物.
结论:我们报告了首例聚氨酯纹理植入物与罕见的EBV+DLBCL相关的病例。我们的目标是更新对晚期假体周围血清肿的临床意义的认识,并强调需要记录所有病例,以增进我们对乳房植入物相关淋巴瘤的了解。
方法:本期刊要求作者为每篇文章分配一定程度的证据。为了完整描述这些循证医学评级,请参阅目录或在线作者说明www。springer.com/00266.
OBJECTIVE: Lymphomas associated with breast implants are mostly of the T-cell type which typically present as a late-onset seroma or palpable mass adjacent to the implant. Primary lymphomas of the breast, in the absence of breast implants, are mostly of the B-cell type. However, we present a
case of an Epstein-Barr virus-positive diffuse large B-cell lymphoma in a patient with polyurethane textured implants.
METHODS: A 75-year-old woman presented with a sudden onset of swelling in her right breast. Her medical history revealed a unilateral mastectomy at the age of 48 for an invasive ductal adenocarcinoma in her left breast. Reconstruction was performed using bilateral McGhan style 150 implants. Nine years later, she was diagnosed with Baker IV capsular contracture and bilateral rupture, as seen on magnetic resonance imaging. A complete capsulectomy with implant change (Polytech, Replicon® SL HP) and mastopexy on the right was performed. Given her history and the sudden onset of swelling, the situation was concerning. Ultrasound showed a large mass in contact with the implant and an effusion around it. After mastectomy with explantation and capsulectomy, she was diagnosed with an Epstein-Barr virus-associated diffuse large B-cell lymphoma (DLBCL) of the
capsule in association with textured breast implants.
CONCLUSIONS: We report the first
case of polyurethane textured implant association with the rare entity of EBV+ DLBCL. Our aim is to renew awareness of the clinical significance of late periprosthetic seroma and highlight the need for documenting all cases to advance our understanding of breast implant-associated lymphoma.
METHODS: This journal requires that authors assign a level of evidence to each article. For a full description of these evidence-based medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .