Primary anaplastic large cell lymphoma of the breast arising in reconstruction mammoplasty capsule of saline filled breast implant after radical mastectomy for breast cancer: an unusual case presentation

In this report we present a case of primary ALCL of the breast arising in reconstruction mamoplasty capsule of saline filled breast implant after radical mastectomy for infiltrating ductal carcinoma followed by postoperative chemotherapy twelve years ago.Primary ALK negative ALCL arising at the site of saline filled breast implant is rare. It is still unclear whether chemotherapy and breast implantation increases risk of secondary hematological malignancies significantly. However, it is important to be aware of these complications and need for careful pathologic examination of tissue removed for implant related complications to make the correct diagnosis for further patient management and treatment. It is important to be aware of this entity at this site as it can be easily misdiagnosed on histologic grounds and to exclude sarcomatoid carcinoma, malignant melanoma and pleomorphic sarcoma by an appropriate panel of immunostains to arrive at the correct diagnosis of ALCL.Primary non-Hodgkin lymphomas (NHL) of the breast are uncommon. NHLs of the breast represent 0.04–0.5% of malignant lesions of the breast and account for 1.7% to 2.2% of extra-nodal NHLs [1,2]. Most primary cases are B-cell phenotype and are more common on the right side with only rare cases showing a T-cell phenotype. The primary lymphomas have been defined by the criteria of Wiseman and Liao, which have been followed by most of the authors with minor modification [3].Anaplastic large cell lymphoma (ALCL) is a rare T-cell lymphoma typically seen in children and young adults. It has been described in numerous sites; however the breast is one of the least common locations. Secondary hematological malignancies after breast cancer chemotherapy have been reported in the literature [4,5]. Acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS) are the common hematological disorders associated with breast cancer chemotherapy [5].In this report we describe a case of ALCL of the left breast arising in