hrvatski

ANAPLASTIČNI LIMFOM VELIKIH STANICA POVEZAN S IMPLANTATIMA ZA DOJKU: PREGLED LITRATURE

AIM: The aim of this review was to summarize what is known about this entity (BIA-ALCL) so far ; in terms of etiology, diagnostics, clinical presentation and treatment. MATERIALS AND METHODS: We conducted a review of the literature available in PubMed and Scopus databases and relevant websites (US Food and Drug Administration, American Society of Plastic Surgeons, The Plastic Surgery Foundation etc.). RESULTS: Anaplastic large cell lymphoma (ALCL) is a rare subtype of non-Hodgkin lymphoma (NHL) and it originates from mature T-lymphocytes. Its subtypes are primary cutaneous ALCL (PC-ALCL), two subtypes of systemic ALCL (ALK-positive and ALK-negative) and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) as a new pathological entity. BIA-ALCL is a distinct form of CD30-positive and ALK-negative ALCL that is proved to arise in association with breast implants, usually 8-10 years after surgery (breast augmentation). The etiopathogenesis of BIA-ALCL is likely to be multifactorial, based on the combination of chronic inflammation (chronic lymphocyte stimulation), biofilm formation, implant texture, patients’ genetic predisposition and time after the augmentation. Breast implants with textured surfaces seem to be associated with nearly all cases of BIA-ALCL so far. The classical clinical presentation is late onset, persistent seroma around breast implant (periprosthetic effusion) or tumor on the inner side of the capsule ; sometimes both are present. In most cases, diagnosis is made by ultrasound imaging, magnetic resonance imaging (MRI), aspiration of periprosthetic fluid, cytologic analysis and immunophenotypic analysis (flow cytometry, immunohistochemistry). Most of the patients present with localized disease, which generally confers an excellent prognosis. Complete surgical excision (removal of the capsule and the implant) has a key role in the treatment. Chemotherapy, radiotherapy, or both are indicated in more advanced cases. CONCLUSIONS: Further research is required in order to understand the causes of this disease completely (reporting cases and collection of data internationally is of utmost importance). It is necessary to raise awareness among medical professionals and inform the patients about potential risks that breast augmentation carries, regardless of reconstructive or aesthetic reasons.

anaplastični limfom velikih stanica ; sistemski anaplastični limfom velikih stanica ; implantat za dojku

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