PMC7275238_01
Breast MRI. Smooth circumferential thickening of the right implant fibrous capsule noted with diffuse progressive enhancement.
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The MRI showed smooth circumferential thickening of the right implant fibrous capsule with diffuse progressive enhancement (Figure 1).
(a, b) Right breast capsule macroscopic appearance. Initial (malignant) capsulectomy specimen showing thickened, "velvety" appearance. (c-f) Right breast peri-implant capsule with exudate, microscopic appearance. Malignant lymphoid cells within the fibrinous exudate show large, irregular nuclei with prominent nucleoli.
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Marked thickening, fibrinous debris, and a "velvety" appearance of the capsular surface were noted (Figures 2(a) and 2(b)). Histological analysis showed that there were atypical lymphoid cells in the fibrinous exudate from around the implant (Figures 2(c)-2(f)).
(a-f) Immunohistochemical staining of the right breast peri-implant capsule with exudate. The malignant lymphoid cells stain positively for CD30 and are negative for CD3, CD20, CD68, and AE1/3.
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Alk, CD2, CD20, CD3, CD4, CD5, CD7, CD8, and Granzyme B were all negative (Figures 3(a)-3(f)).
(a, b) Reresection of the right breast peri-implant capsule with exudate, microscopic appearance. Marked synovial metaplasia of the capsule and focal infiltration by small lymphocytes. No evidence of residual malignancy.
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Histological sections showed marked synovial metaplasia of the capsule and focal infiltration by small lymphocytes (Figures 4(a) and 4(b)).