Breast Implant- Associated Anaplastic Large Cell Lymphoma:
FDG PET/CT imaging

Figure 1: Mild-moderate uptake in peri-capsular effusion in the left breast.

Figure 2: mild uptake in an axillary lymph-node, considered to be reactive.

 


Figure 3: No pathological FDG uptake, post implants-removal and capsulectomy.

Description:

A 37-y- old female with swelling of her left breast 8 years following breast-augmentation surgery, was diagnosed with Breast Implant- Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). The patient underwent an FDG PET-CT for staging, which showed faint uptake in a peri-capsular effusion in the left breast. Mild uptake was noted in an axillary lymph-node, considered as reactive.

Follow-up FDG PET-CT, performed six months post implants removal and capsulectomy showed no pathological uptake in the breast parenchyma or in regional lymph-nodes suggestive of complete remission.

 

Discussion:

BIA-ALCL is a rare T-cell lymphoma, and often underdiagnosed. It is not a disease of the breast parenchyma, but a disease of the fibrous capsule. Diagnosis is based on sampling of the effusion and histologic sampling of breast tissue collected during capselectomy. FDG PET/CT is recommended as the modality of choice to exclude systemic lymphoma and for follow-up after treatment.


References:

  1. Adarade BE, et al. Breast implant-associated anaplastic large cell lymphoma: sensitivity, specificity, and findings of imaging studies in 44 patients. Breast Cancer Res Treat. 2014; 147:1-14.
  2. Clemens MW, et al. Understanding rare adverse sequelae of breast implants: anaplastic large-cell lymphoma, late seromas, and double capsules. Gland Surg. 2017; 6: 169-184.
  3. Acevedo Banez I, et al. 18F-FDG-PET/CT in implant-associated anaplastic large cell lymphoma of the breast. Br J Haematol. 2015; 169: 1.

 

This Case was kindly provided by:

Dr. Jonathan Kuten MD MHA
Dept. of Nuclear Medicine,
Tel Aviv Sourasky Medical Center,
6 Weizmann St., Tel Aviv, 4263906 Israel.

Tel: +972-3-6973536, FAX: +972-3-6973895
Contact

Prof. Einat Even-Sapir MD, Phd
Head, Dept of Nuclear Medicine,
Tel Aviv Sourasky Medical Center,
Tel Aviv University

 

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