PMC6243353_01
Pleomorphic lymphoid cells present in the aspirated effusion. Subsequent immunohistochemical staining confirmed this to be breast implant-associated anaplastic large cell lymphoma.
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fig1
Cytological examination revealed malignancy, showing a population of lymphoid cells (Figure 1) that were positive for CD45, CD30, CD3, CD2 and CD4, and negative for EMA, CD20, CD79a and ALK-1.
Pre-operative contrast-enhanced CT scan (a) axial and (b) coronal views demonstrating right mastectomy with implant and associated effusion in the implant cavity.
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fig2
A contrast-enhanced CT scan of the chest, abdomen and pelvis confirmed an effusion within the right breast implant cavity (Figure 2) and showed no other evidence of disease.
(a) Axial and (b) coronal views ofpost-operative 18F-fludeoxyglucose positron emission tomography-CT demonstrating low level metabolic activity at the operative site, likely owingtopost-operative inflammation.
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fig3
A post-operative FDG PET-CT scan showed only low level metabolic activity [maximum standardized uptake (SUV) value of 2.4] that was limited to the chest wall at the recent operative site, which was considered postsurgical (Figure 3).
(a) Axial and (b) coronal views of 18F-fludeoxyglucose positron emission tomography-CT performed 3 months postoperatively demonstrating reduction of previous 18F-fludeoxyglucose uptake.
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fig4
At 3 months, there was no evidence of recurrence on repeat FDG PET-CT scan (Figure 4).
(a) Axial and (b) coronal views of 18F-fludeoxyglucose PET-CT scan performed 12 months postoperatively showing complete resolution of previous 18F-fludeoxyglucose uptake with no evidence of 18F-fludeoxyglucose-avid disease.
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fig5
A 12-month FDG PET-CT scan (Figure 5) showed resolution of the previous FDG uptake, with no evidence of FDG-avid disease.