Background
Textured breast implants are well recognised in the development of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Further concern around safety has increased with more recent reports of BIA-squamous cell carcinoma(1). This case reports New Zealand’s first BIA-EBV positive B-cell lymphoma, captures its clinical and histological features, and supplements the 14 previously reported cases worldwide.
Clinical Case
A 56-year-old woman with previous breast augmentation presented to Plastic Surgery Outpatients clinic with Baker Grade 4 capsular contracture. Her initial augmentation was performed in 2008 with Eurosilicone textured implants. She underwent routine bilateral capsulectomy and implant removal under general anaesthetic. The left side revealed a double capsule but was otherwise unremarkable. The right was thickened but had no other macroscopically suspicious elements. Suction drains were placed in each surgical pocket, and she underwent an uneventful recovery. Histological analysis of her right breast capsule revealed fibrin associated large B-cell lymphoma (FA-LBCL). Immunohistochemistry was positive for CD30, CD20, EBER, MUM1, BCL2 and Ki67. Postoperatively a whole-body PET-CT and an MRI of the right breast were both negative for metastatic disease. She did not require adjuvant chemoradiotherapy but given the rarity of the diagnosis continues clinical surveillance with Medical Oncology.
Discussion
This is the first case of fibrin associated large B-cell lymphoma (FA-LBCL) reported in New Zealand. There are no cases of biopsy-proven FA-LBCL progressing to disseminated disease, and most cases are indolent and resolve with complete removal of the underlying lesion(2). This report adds to the collective understanding of this extremely rare disease.