TY - JOUR
T1 - Epstein–Barr-virus-positive large B-cell lymphoma associated with breast implants
T2 - an analysis of eight patients suggesting a possible pathogenetic relationship
AU - Medeiros, L. Jeffrey
AU - Marques-Piubelli, Mario L.
AU - Sangiorgio, Valentina F.I.
AU - Ruiz-Cordero, Roberto
AU - Vega, Francisco
AU - Feldman, Andrew L.
AU - Chapman, Jennifer R.
AU - Clemens, Mark W.
AU - Hunt, Kelly K.
AU - Evans, Mark G.
AU - Khoo, Christine
AU - Lade, Stephen
AU - Silberman, Mark
AU - Morkowski, Jerzy
AU - Pina, Edward M.
AU - Mills, Daniel C.
AU - Bates, Christopher M.
AU - Magno, Winston B.
AU - Sohani, Aliyah R.
AU - Sieling, Beth A.
AU - O’Donoghue, Joseph M.
AU - Bacon, Chris M.
AU - Patani, Neill
AU - Televantou, Despina
AU - Turner, Suzanne D.
AU - Johnson, Laura
AU - MacNeill, Fiona
AU - Wotherspoon, Andrew C.
AU - Iyer, Swaminathan P.
AU - Malpica, Luis E.
AU - Patel, Keyur P.
AU - Xu, Jie
AU - Miranda, Roberto N.
N1 - Publisher Copyright:
© 2021, The Author(s), under exclusive licence to United States & Canadian Academy of Pathology.
PY - 2021/12
Y1 - 2021/12
N2 - Breast implant anaplastic large cell lymphoma (ALCL) is a T-cell neoplasm arising around textured breast implants that was recognized recently as a distinct entity by the World Health Organization. Rarely, other types of lymphoma have been reported in patients with breast implants, raising the possibility of a pathogenetic relationship between breast implants and other types of lymphoma. We report eight cases of Epstein–Barr virus (EBV)-positive large B-cell lymphoma associated with breast implants. One of these cases was invasive, and the other seven neoplasms were noninvasive and showed morphologic overlap with breast implant ALCL. All eight cases expressed B-cell markers, had a non-germinal center B-cell immunophenotype, and were EBV+ with a latency type III pattern of infection. We compared the noninvasive EBV+ large B-cell lymphoma cases with a cohort of breast implant ALCL cases matched for clinical and pathologic stage. The EBV+ large B-cell lymphoma cases more frequently showed a thicker capsule, and more often were associated with calcification and prominent lymphoid aggregates outside of the capsule. The EBV+ B-cell lymphoma cells were more often arranged within necrotic fibrinoid material in a layered pattern. We believe that this case series highlights many morphologic similarities between EBV+ large B-cell lymphoma and breast implant ALCL. The data presented suggest a pathogenetic role for breast implants (as well as EBV) in the pathogenesis of EBV+ large B-cell lymphoma. We also provide some histologic findings useful for distinguishing EBV+ large B-cell lymphoma from breast implant ALCL in this clinical setting.
AB - Breast implant anaplastic large cell lymphoma (ALCL) is a T-cell neoplasm arising around textured breast implants that was recognized recently as a distinct entity by the World Health Organization. Rarely, other types of lymphoma have been reported in patients with breast implants, raising the possibility of a pathogenetic relationship between breast implants and other types of lymphoma. We report eight cases of Epstein–Barr virus (EBV)-positive large B-cell lymphoma associated with breast implants. One of these cases was invasive, and the other seven neoplasms were noninvasive and showed morphologic overlap with breast implant ALCL. All eight cases expressed B-cell markers, had a non-germinal center B-cell immunophenotype, and were EBV+ with a latency type III pattern of infection. We compared the noninvasive EBV+ large B-cell lymphoma cases with a cohort of breast implant ALCL cases matched for clinical and pathologic stage. The EBV+ large B-cell lymphoma cases more frequently showed a thicker capsule, and more often were associated with calcification and prominent lymphoid aggregates outside of the capsule. The EBV+ B-cell lymphoma cells were more often arranged within necrotic fibrinoid material in a layered pattern. We believe that this case series highlights many morphologic similarities between EBV+ large B-cell lymphoma and breast implant ALCL. The data presented suggest a pathogenetic role for breast implants (as well as EBV) in the pathogenesis of EBV+ large B-cell lymphoma. We also provide some histologic findings useful for distinguishing EBV+ large B-cell lymphoma from breast implant ALCL in this clinical setting.
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U2 - 10.1038/s41379-021-00863-1
DO - 10.1038/s41379-021-00863-1
M3 - Article
C2 - 34226673
AN - SCOPUS:85109974532
SN - 0893-3952
VL - 34
SP - 2154
EP - 2167
JO - Modern Pathology
JF - Modern Pathology
IS - 12
ER -