ABSTRACT
BACKGROUND: Primary anaplastic large-cell lymphoma (ALCL) occurring in women with breast implants is very rare. It is usually described as tumor cells infiltrating the periprosthetic capsule. These are most often revealed by a periprosthetic recurrent isolated effusion (seroma cavity), occurring late after implantation of the prosthesis. ALCL is more rarely a tumor or periprosthetic capsular contracture. CASE: We report a 66-year-old woman, initially diagnosed by cytological examination of breast effusion, in whom ALCL appeared two and a half months after the removal of a ruptured implant. Repeated biopsies of the periprosthetic capsule performed in parallel showed fibrous tissue, without tumor proliferation. Only meticulous histological examination of the total capsulectomy identified tumor cells as a thin and discontinuous layer along the inner surface of the capsule without capsular invasion. CONCLUSION: Awareness of the histological pattern of this new clinical entity is important. A total capsulectomy with a good sampling for microscopic examination should be conducted for any suspicion of breast implant-associated ALCL. Cytology-histology correlation is essential.
Subject(s)
Breast Implants/adverse effects , Breast Neoplasms/pathology , Lymphoma, Large-Cell, Anaplastic/pathology , Neoplasms, Second Primary/pathology , Adenocarcinoma/surgery , Aged , Breast Neoplasms/etiology , Female , Humans , Lymphoma, Large-Cell, Anaplastic/etiology , Neoplasms, Second Primary/etiology , Prosthesis FailureABSTRACT
Malignant melanoma is a relatively rare but potentially aggressive tumor in children and adolescents. We report the case of a metastatic malignant melanoma in a 17-year-old girl, first diagnosed on cytological features of a fine-needle lymph node aspiration and then histologically confirmed by both examination of the metastatic adenopathy and a clinically harmless skin lesion of the scalp, which harbored focal microscopic pattern of melanoma. A fluorescent in situ hybridization study revealed that both metastatic and primary cutaneous tumours contained the same and pejorative chromosomal aberration consisting in CCND1 amplification (11q13). This observation raises actual limits and challenges in the fields of diagnosis and treatment of fast-killing melanomas.
Subject(s)
Head and Neck Neoplasms/diagnosis , Melanoma/diagnosis , Neoplasms, Second Primary/diagnosis , Scalp/pathology , Skin Neoplasms/diagnosis , Adolescent , Antibodies, Monoclonal/therapeutic use , Antineoplastic Agents, Alkylating/therapeutic use , Back Pain/etiology , Combined Modality Therapy , Cyclin D1/genetics , Dacarbazine/therapeutic use , Drug Resistance, Neoplasm , Fatal Outcome , Female , Gene Amplification , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/genetics , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/surgery , Humans , Immunotherapy , In Situ Hybridization, Fluorescence , Ipilimumab , Lymphatic Metastasis/diagnosis , Melanoma/drug therapy , Melanoma/genetics , Melanoma/pathology , Melanoma/secondary , Melanoma/surgery , Nausea/etiology , Neoplasm Proteins/genetics , Neoplasms, Second Primary/genetics , Neoplasms, Second Primary/pathology , Nevus/pathology , Osteolysis/etiology , Skin Neoplasms/genetics , Skin Neoplasms/pathology , Weight LossABSTRACT
OBJECTIVE: This study aims to evaluate the interest to systematically combine cytology and histology for all bone specimens. METHODS: We reviewed all the bone biopsies performed in the University Hospital of Brest, France, between January 2000 and March 2008 and for which cytology and histology, obtained at the same time, were available. The interest of cytology and histology, alone and in combination was studied in comparison with the diagnostic made by the practitioner who treated the patient, which was considered the reference. RESULTS: Seventy patients were included. Among them, 55 had a final diagnosis of cancer. Thirty-nine of them were identified either by cytology or histology: twenty-five were identified by the two techniques, eight only by histology, and six only by cytology. There was no false-positive result, but false-negative results occurred with cytology (n=3) and histology (n=4). The agreement malignancy/benignancy was high (κ=0.84) between cytology and histology when taking into account the only contributive results. It dropped to 0.52 when taking into account all the samples. CONCLUSION: Cytology and histology are complementary to each other in diagnosing bone lesion. Combining cytomorphology and tissue architecture increases the accuracy of bone sample and would systematically be performed for each bone biopsy.
