Breast implant associated EBV-positive Diffuse Large B-cell lymphoma: an underrecognized entity?

Abstract Breast-implant associated (BIA) lymphoma is an infrequent type of cancer occurring in the fluid and fibrous capsule around a textured breast implant. Recently, both the 2022 WHO 5th edition classification of Haematological tumours (WHO HAEM5) and 2022 International Consensus Classification...

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Main Authors: Johanna Vets, Lukas Marcelis, Charlotte Schepers, Yaliva Dorreman, Sanne Verbeek, Lieve Vanwalleghem, Katrien Gieraerts, Liesbeth Meylaerts, Jan Lesaffer, Helena Devos, Natalie Put, Sylvia Snauwaert, Pascale De Paepe, Thomas Tousseyn
Format: Article
Language:English
Published: BMC 2023-04-01
Series:Diagnostic Pathology
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Online Access:https://doi.org/10.1186/s13000-023-01337-5
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author Johanna Vets
Lukas Marcelis
Charlotte Schepers
Yaliva Dorreman
Sanne Verbeek
Lieve Vanwalleghem
Katrien Gieraerts
Liesbeth Meylaerts
Jan Lesaffer
Helena Devos
Natalie Put
Sylvia Snauwaert
Pascale De Paepe
Thomas Tousseyn
author_facet Johanna Vets
Lukas Marcelis
Charlotte Schepers
Yaliva Dorreman
Sanne Verbeek
Lieve Vanwalleghem
Katrien Gieraerts
Liesbeth Meylaerts
Jan Lesaffer
Helena Devos
Natalie Put
Sylvia Snauwaert
Pascale De Paepe
Thomas Tousseyn
author_sort Johanna Vets
collection DOAJ
description Abstract Breast-implant associated (BIA) lymphoma is an infrequent type of cancer occurring in the fluid and fibrous capsule around a textured breast implant. Recently, both the 2022 WHO 5th edition classification of Haematological tumours (WHO HAEM5) and 2022 International Consensus Classification of Mature Lymphoid Neoplasms (22ICC), recognized breast implant-associated Anaplastic Large Cell Lymphoma (BIA-ALCL) as a definitive entity, defined as a mature CD30-positive T-cell lymphoma, confined by a fibrous capsule, in a breast implant setting. Only few B-cell lymphomas have been reported in the literature to be associated with breast implants. Here we report two EBV-positive Diffuse Large B-cell lymphomas (EBV + DLBCL) in relation to a breast implant, both expressing CD30 as well as EBV latency type 3. Both lesions were considered as DLBCL associated with chronic inflammation (CI-DLBCL), but one presented as a 7 cm solid mass, while the other presented as a fibrin-associated DLBCL (FA-DLBCL) in an HIV patient. Clinically, both are in complete remission 6 months or longer after capsulectomy and graft removal, without additional chemotherapy. Such cases, characterized by large CD30-positive cells, can easily be misdiagnosed as BIA-ALCL if the cell of origin is not further established. Therefore, a diagnostic panel including lineage-specific B-and T-cell markers and EBER in situ hybridization is essential to recognize this rare entity, to understand lymphomagenesis, to predict outcome and to define clinical approach.
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spelling doaj.art-b9c1bade62b34d09a6eb443e0769cbc32023-04-30T11:05:48ZengBMCDiagnostic Pathology1746-15962023-04-0118111110.1186/s13000-023-01337-5Breast implant associated EBV-positive Diffuse Large B-cell lymphoma: an underrecognized entity?Johanna Vets0Lukas Marcelis1Charlotte Schepers2Yaliva Dorreman3Sanne Verbeek4Lieve Vanwalleghem5Katrien Gieraerts6Liesbeth Meylaerts7Jan Lesaffer8Helena Devos9Natalie Put10Sylvia Snauwaert11Pascale De Paepe12Thomas Tousseyn13Translational Cell and Tissue Research Laboratory, KU LeuvenTranslational Cell and Tissue Research Laboratory, KU LeuvenDepartment of Pathology, UZ Leuven, University HospitalsDepartment of Oncological Surgery, UZ GhentDepartment of Pathology, ZOLDepartment of Pathology, AZ Sint-JanDepartment of Radiology, AZ Sint-JanDepartment of Radiology, ZOLDepartment of Oncological Surgery, Sint-JanDepartment of Laboratory Medicine, AZ Sint-JanDepartment of Hematology, ZOLDepartment of Hematology, AZ Sint-JanDepartment of Pathology, AZ Sint-JanTranslational Cell and Tissue Research Laboratory, KU LeuvenAbstract Breast-implant associated (BIA) lymphoma is an infrequent type of cancer occurring in the fluid and fibrous capsule around a textured breast implant. Recently, both the 2022 WHO 5th edition classification of Haematological tumours (WHO HAEM5) and 2022 International Consensus Classification of Mature Lymphoid Neoplasms (22ICC), recognized breast implant-associated Anaplastic Large Cell Lymphoma (BIA-ALCL) as a definitive entity, defined as a mature CD30-positive T-cell lymphoma, confined by a fibrous capsule, in a breast implant setting. Only few B-cell lymphomas have been reported in the literature to be associated with breast implants. Here we report two EBV-positive Diffuse Large B-cell lymphomas (EBV + DLBCL) in relation to a breast implant, both expressing CD30 as well as EBV latency type 3. Both lesions were considered as DLBCL associated with chronic inflammation (CI-DLBCL), but one presented as a 7 cm solid mass, while the other presented as a fibrin-associated DLBCL (FA-DLBCL) in an HIV patient. Clinically, both are in complete remission 6 months or longer after capsulectomy and graft removal, without additional chemotherapy. Such cases, characterized by large CD30-positive cells, can easily be misdiagnosed as BIA-ALCL if the cell of origin is not further established. Therefore, a diagnostic panel including lineage-specific B-and T-cell markers and EBER in situ hybridization is essential to recognize this rare entity, to understand lymphomagenesis, to predict outcome and to define clinical approach.https://doi.org/10.1186/s13000-023-01337-5EBV + DLBCLBreast implant associated lymphomaBIA-DLBCLFA-DLBCLCI-DLBCL
spellingShingle Johanna Vets
Lukas Marcelis
Charlotte Schepers
Yaliva Dorreman
Sanne Verbeek
Lieve Vanwalleghem
Katrien Gieraerts
Liesbeth Meylaerts
Jan Lesaffer
Helena Devos
Natalie Put
Sylvia Snauwaert
Pascale De Paepe
Thomas Tousseyn
Breast implant associated EBV-positive Diffuse Large B-cell lymphoma: an underrecognized entity?
Diagnostic Pathology
EBV + DLBCL
Breast implant associated lymphoma
BIA-DLBCL
FA-DLBCL
CI-DLBCL
title Breast implant associated EBV-positive Diffuse Large B-cell lymphoma: an underrecognized entity?
title_full Breast implant associated EBV-positive Diffuse Large B-cell lymphoma: an underrecognized entity?
title_fullStr Breast implant associated EBV-positive Diffuse Large B-cell lymphoma: an underrecognized entity?
title_full_unstemmed Breast implant associated EBV-positive Diffuse Large B-cell lymphoma: an underrecognized entity?
title_short Breast implant associated EBV-positive Diffuse Large B-cell lymphoma: an underrecognized entity?
title_sort breast implant associated ebv positive diffuse large b cell lymphoma an underrecognized entity
topic EBV + DLBCL
Breast implant associated lymphoma
BIA-DLBCL
FA-DLBCL
CI-DLBCL
url https://doi.org/10.1186/s13000-023-01337-5
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