Cytological diagnostic features of late breast implant seromas: From reactive to anaplastic large cell lymphoma

• DOI: 10.1371/journal.pone.0181097
• Publication Date: 2017-07-17T17:43:41Z
• Authors: Arianna Di Napoli; Giuseppina Pepe; Enrico Giarnieri; Claudia Cippitelli; Adriana Bonifacino; Mauro Mattei; Maurizio Martelli; Carlo Falasca; Maria Christina Cox; Iolanda Santino; Maria Rosaria Gio...
• Keywords: Anaplastic large-cell lymphoma; Breast implant; Seroma; Histology; Cytopathology

Late breast implant seroma may be the presentation of a implant-associated anaplastic large cell lymphoma (BI-ALCL), which claims for prompt recognition. However, BI-ALCL diagnosis on fine-needle aspiration (FNA) might challenging pathologists lacking experience with peri-implant effusions. Sixty-seven late seromas collected by FNA from 50 patients were evaluated Papanicolaou smear stain and immunocytochemistry blocks. A diagnostic algorithm based cellular composition, morphology percentage CD30+ cells was developed. Histological evaluation corresponding peri-prosthetic capsules also performed. Most effusions (91% samples) classified as reactive 9% BI-ALCL. In cases, medium-to-large atypical expressing CD30 represented more than 70% cellularity, whereas in elements extremely rare (<5%) consisted non-atypical elements. The categorized into three patterns: i) acute infiltrate prominent neutrophilic component (33% samples); ii) mixed characterized variable number neutrophils, lymphocytes macrophages (30% iii) chronic composed predominantly T or only sporadic granulocytes (37% samples). inflammatory cytological patterns consistent histology capsules. Our results indicate that analysis effusions, supported knowledge heterogeneous cytomorphological spectrum seromas, is valuable approach early recognition