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Epstein-Barr-virus-positive large B-cell lymphoma associated with breast implants: an analysis of eight patients suggesting a possible pathogenetic relationship.

Accepted version
Peer-reviewed

Type

Article

Change log

Authors

Medeiros, L Jeffrey  ORCID logo  https://orcid.org/0000-0001-6577-8006
Marques-Piubelli, Mario L  ORCID logo  https://orcid.org/0000-0002-6324-2096
Sangiorgio, Valentina FI 
Ruiz-Cordero, Roberto  ORCID logo  https://orcid.org/0000-0002-9747-6069

Abstract

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.

Description

Keywords

Adult, Aged, Biomarkers, Tumor, Breast Implantation, Breast Implants, Diagnosis, Differential, Epstein-Barr Virus Infections, Female, Humans, Lymphoma, Large B-Cell, Diffuse, Lymphoma, Large-Cell, Anaplastic, Middle Aged, Neoplasm Staging, Predictive Value of Tests, Prosthesis Design, Risk Factors, Surface Properties

Journal Title

Mod Pathol

Conference Name

Journal ISSN

0893-3952
1530-0285

Volume Title

Publisher

Elsevier BV

Rights

All rights reserved