UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma on behalf of the Medicines and Healthcare products Regulatory Agency Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group

Turton, P.; El-Sharkawi, D.; Lyburn, I.; Sharma, B.; Mahalingam, P.; Turner,  Suzanne Dawn; MacNeill, F.; Johnson, L.; Hamilton, S.; Burton, C.; Mercer, N.

UK Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma on behalf of the Medicines and Healthcare products Regulatory Agency Plastic, Reconstructive and Aesthetic Surgery Expert Advisory Group

Varování

Publikace nespadá pod Lékařskou fakultu, ale pod Středoevropský technologický institut. Oficiální stránka publikace je na webu muni.cz.

Autoři	TURTON P. EL-SHARKAWI D. LYBURN I. SHARMA B. MAHALINGAM P. TURNER Suzanne Dawn MACNEILL F. JOHNSON L. HAMILTON S. BURTON C. MERCER N.
Rok publikování	2021
Druh	Článek v odborném periodiku
Časopis / Zdroj	BRITISH JOURNAL OF HAEMATOLOGY
Fakulta / Pracoviště MU	Středoevropský technologický institut
Citace
www	https://onlinelibrary.wiley.com/doi/10.1111/bjh.17194
Doi	http://dx.doi.org/10.1111/bjh.17194
Klíčová slova	BIA-ALCLreconstructive breast surgerylymphomabreast implantstreatment guidelines
Popis	Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon T-cell non-Hodgkin Lymphoma (NHL) associated with breast implants. Raising awareness of the possibility of BIA-ALCL in anyone with breast implants and new breast symptoms is crucial to early diagnosis. The tumour begins on the inner aspect of the peri-implant capsule causing an effusion, or less commonly a tissue mass to form within the capsule, which may spread locally or to more distant sites in the body. Diagnosis is usually made by cytological, immunohistochemical and immunophenotypic evaluation of the aspirated peri-implant fluid: pleomorphic lymphocytes are characteristically anaplastic lymphoma kinase (ALK)-negative and strongly positive for CD30. BIA-ALCL is indolent in most patients but can progress rapidly. Surgical removal of the implant with the intact surrounding capsule (total en-bloc capsulectomy) is usually curative. Late diagnosis may require more radical surgery and systemic therapies and although these are usually successful, poor outcomes and deaths have been reported. By adopting a structured approach, as suggested in these guidelines, early diagnosis and successful treatment will minimise the need for systemic treatments, reduce morbidity and the risk of poor outcomes.