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

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.