Nonmalignant CD30+ Cells in Contralateral Peri-Implant Capsule of Patient With BIA-ALCL: A Premalignant Step?

Abstract

CD30 lymphocyte activation antigen and phosphorylated STAT3 (pSTAT3) are consistent markers of tumor cells in breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). We present a case of BIA-ALCL in a breast implant capsule containing clustered tumor cells expressing CD30, pSTAT3, pSTAT6, interleukin 9, and granzyme B tumor cell biomarkers. Remarkably, the contralateral breast contained many scattered large, atypical CD30+ cells surrounded by inflammatory cells, raising a suspicion of bilateral BIA-ALCL, known to occur in some patients. To clarify the diagnosis, immunohistochemistry and multilabel immunofluorescence were performed. Unlike the tumor cells, the atypical CD30+ cells of the contralateral breast lacked pSTAT3, pSTAT6, interleukin 9, and granzyme B, eliminating a diagnosis of bilateral BIA-ALCL. This case highlights the importance of interpreting CD30 staining in the context of other tumor cell biomarkers and histopathology to avoid an incorrect diagnosis of BIA-ALCL. We believe the findings also suggest the possibility of CD30 expression as an early event in the multistep pathogenesis of BIA-ALCL.

LEVEL OF EVIDENCE: 5:

• Authors: Marshall E Kadin, Haiying Xu, Lisa M Hunsicker, Yingjie Guan
• Journal: Aesthetic surgery journal (Aesthet Surg J) Vol. 42 Issue 2 Pg. NP125-NP129 (01 12 2022) ISSN: 1527-330X [Electronic] England
• PMID: 33944901 (Publication Type: Case Reports, Journal Article)
• Copyright: © 2021 The Aesthetic Society. Reprints and permission: [email protected].

Chemical References

• Ki-1 Antigen

Topics

• Breast
• Breast Implantation (adverse effects)
• Breast Implants (adverse effects)
• Breast Neoplasms (etiology)
• Female
• Humans
• Ki-1 Antigen
• Lymphoma, Large-Cell, Anaplastic (diagnosis, etiology)