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Role of flow cytometric immunophenotyping in the diagnosis of breast implant-associated anaplastic large cell lymphoma: A 6-year, single-institution experience.
Chan, Alexander; Auclair, Romany; Gao, Qi; Ghione, Paola; Horwitz, Steven; Dogan, Ahmet; Roshal, Mikhail; Lin, Oscar.
Afiliación
  • Chan A; Department of Pathology, Hematopathology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Auclair R; Department of Pathology, Hematopathology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Gao Q; Colusa Medical Center, Colusa, California, USA.
  • Ghione P; Department of Pathology, Hematopathology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Horwitz S; Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, USA.
  • Dogan A; Department of Medicine, Lymphoma Service, Memorial Sloan Kettering Cancer Center, New York, USA.
  • Roshal M; Department of Pathology, Hematopathology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
  • Lin O; Department of Pathology, Hematopathology Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA.
Cytometry B Clin Cytom ; 106(2): 117-125, 2024 03.
Article en En | MEDLINE | ID: mdl-38297808
ABSTRACT
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is an uncommon mature T-cell neoplasm occurring in patients with textured breast implants, typically after 7-10 years of exposure. Although cytopathologic or histopathologic assessment is considered the gold standard diagnostic method for BIA-ALCL, flow cytometry (FC)-based immunophenotyping is recommended as an adjunct test. However, the diagnostic efficacy of FC is not well reported. We reviewed 290 FC tests from breast implant pericapsular fluid and capsule tissue from 182 patients, including 16 patients with BIA-ALCL over a 6-year period, calculating diagnostic rates and test efficacy. FC showed an overall sensitivity of 75.9%, specificity of 100%, and negative and positive predictive values of 95.4% and 100%, respectively. Blinded expert review of false-negative cases identified diagnostic pitfalls, improving sensitivity to 96.6%. Fluid samples had better rates of adequate samples for FC testing compared with tissue samples. Paired with FC testing of operating room (OR)-acquired fluid samples, capsulectomy FC specimens added no diagnostic value in patients with concurrent fluid samples; no cases had positive capsule FC with negative fluid FC. Fluid samples are adequate for FC testing more often than tissue. Capsule tissue FC specimens do not improve FC efficacy when paired with OR-acquired fluid FC samples and are often inadequate samples. FC is 100% specific for BIA-ALCL and can serve as a confirmatory test but should not be the sole diagnostic method. Awareness of sample-specific diagnostic pitfalls greatly improves the sensitivity of BIA-ALCL testing by FC.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Linfoma Anaplásico de Células Grandes / Implantes de Mama / Implantación de Mama Tipo de estudio: Diagnostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Cytometry B Clin Cytom Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias de la Mama / Linfoma Anaplásico de Células Grandes / Implantes de Mama / Implantación de Mama Tipo de estudio: Diagnostic_studies / Risk_factors_studies Límite: Female / Humans Idioma: En Revista: Cytometry B Clin Cytom Año: 2024 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos