Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2024 Aug;116(4):242-248.
doi: 10.32074/1591-951X-944.

Fibrin associated large B-cell lymphoma accidentally identified in a breast implant capsule: a molecular report of a rare entity

Cristian Scatena #  1   2 , Antonio Giuseppe Naccarato #  1   2 , Margherita Vannucchi  3 , Maria Chiara Siciliano  3 , Angelo Giovanni Bonadio  2 , Livio Colizzi  4 , Matteo Ghilli  4 , Arianna Di Napoli  5 , Giuseppe Nicolò Fanelli #  1   2 , Stefano Lazzi #  3
Affiliations
Case Reports

Fibrin associated large B-cell lymphoma accidentally identified in a breast implant capsule: a molecular report of a rare entity

Cristian Scatena et al. Pathologica. 2024 Aug.

Abstract

Breast implant-associated (BIA) lymphoma is a rare malignancy, typically originating from T-cells; however, few cases of diffuse large B-cell lymphoma (LBCL) have been recently described. These cases share major features: Epstein-Barr virus positivity and a favorable prognosis with surgical intervention alone, hinting at a potential link to fibrin-associated LBCL (FA-LBCL). This study presents the first case of BIA-FA-LBCL in Italy and one of the few assessed from a molecular standpoint so far. We identified two pathogenic mutations in DNMT3A and a variant of uncertain significance (VUS) in JAK2. These findings suggest that dysfunctional epigenetic mechanisms and constitutive activation of the JAK-STAT pathway may underpin BIA-FA-LBCL lymphomagenesis. Finally, we summarized all the previously reported cases in alignment with the updated WHO-HAEM5 classification, shedding further light on the nature of this new entity. This report highlights the rarity of BIA-FA-LBCL and underscores the importance of comprehensive capsule sampling and reporting to national databases for accurate characterization and management of these lymphomas. The study supports the classification of BIA-FA-LBCL within the spectrum of FA-LBCL, emphasizing the need for further research to elucidate its molecular underpinnings and improve clinical outcomes.

Keywords: breast implant associated lymphoma; fibrin associated-large B cell lymphoma; non-Hodgkin lymphoma.

PubMed Disclaimer

Conflict of interest statement

C.S. has received honoraria for consulting, advisory role, speaker bureau and/or research grants from Bristol Myers Squibb, Astra Zeneca, Daiichi-Sankyo, Gilead, Roche SPA and Novartis. A.D.N. has received honoraria for consulting from Novartis, Menarini, Incyte, EusaPharma and research grants from the Italian Ministry of Health. G.N.F has received honoraria for advisory role from Astra Zeneca.

Figures

Figure 1.
Figure 1.
Schematic representation of the morphological and immunophenotypical features of the current case. (A-B) Small clusters of large, atypical, and pleomorphic lymphocytes with prominent nucleoli distributed within the capsule and associated with fibrin deposits and necrosis (A-B hematoxylin & eosin). Immunoreactivity for CD20 (C), EBER-ISH (D), BCL2 (E), CD30 (F), MUM1 (G). Proliferation index (Ki-67): 90% (H). A gross investigation of the total capsulectomy showed areas of hemorrhage and myxoid necrosis, and a smooth and pale surface, without fluid content and/or tumor mass (I). Magnification of A, C-H: 100X. Magnification of B: 40X. Scalebar of A-H: 100 μm. Scalebar of I: 1 cm.
Figure 2.
Figure 2.
Oncoplot summarizing the major molecular features of the current case compared to literature.
See this image and copyright information in PMC

References

    1. Martin de Bustamante JM, Mendoza A, Lopez-Munoz S, et al. . A New Face of Fibrin-Associated Large B-Cell Lymphoma: Epstein-Barr Virus-Positive Breast Implant-Associated Diffuse Large B-Cell Lymphoma. J Clin Med 2023;12:3614 https://doi.org:10.3390/jcm12113614 10.3390/jcm12113614 - DOI - PMC - PubMed
    1. Di Napoli A, Soma L, Quintanilla-Martinez L, et al. . Cavity-based lymphomas: challenges and novel concepts. A report of the 2022 EA4HP/SH lymphoma workshop. Virchows Arch 2023;483:299-316. https://doi.org:10.1007/s00428-023-03599-2 10.1007/s00428-023-03599-2 - DOI - PMC - PubMed
    1. WHO Classification of Tumours Editorial Board. Haematolymphoid tumours 5th edition, https://tumourclassification.iarc.who.int/chapters/63/150 Lyon, France: International Agency for Research on Cancer, 2022.
    1. Mescam L, Camus V, Schiano JM, et al. . EBV+ diffuse large B-cell lymphoma associated with chronic inflammation expands the spectrum of breast implant-related lymphomas. Blood 2020;135:2004-2009. https://doi.org:10.1182/blood.2019003408 10.1182/blood.2019003408 - DOI - PubMed
    1. Khoo C, McTigue C, Hunter-Smith DJ, et al. . EBV positive fibrin/chronic inflammation associated diffuse large B-cell lymphoma: an incidental finding associated with a breast implant. Pathology 2021;53:673-675. https://doi.org:10.1016/j.pathol.2020.09.022 10.1016/j.pathol.2020.09.022 - DOI - PubMed

Publication types

LinkOut - more resources