Cell of Origin and Immunological Events in the Pathogenesis of Breast Implant-Associated Anaplastic Large Cell Lymphoma.

Cell of Origin and Immunological Events in the Pathogenesis of Breast Implant-Associated Anaplastic Large Cell Lymphoma. Am J Pathol. 2019 Oct 11;: Authors: Turner SD, Inghirami G, Miranda RN, Kadin ME Abstract Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a CD30-positive, anaplastic lymphoma kinase-negative T-cell lymphoma. Nearly all cases have been associated with textured implants. Most cases are of effusion-limited, indolent disease, with an excellent prognosis following implant and capsule removal. However, capsular invasion and tumor mass has a more aggressive course, and a fatal outcome risk. This review summarizes the current knowledge on BIA-ALCL cell of origin and immunological factors underlying its pathogenesis. Cytokine expression profiling of BIA-ALCL cell lines and clinical specimens reveal a predominantly Th17/Th1 signature, implicating this as its cell of origin. However, a Th2 allergic inflammatory response is suggested by the presence of interleukin-13, with infiltration of eosinophils and IgE-coated mast cells in clinical specimens of BIA-ALCL. The microenvironment-induced T-cell plasticity, a factor increasingly appreciated, may partially explain these divergent results. Mutations resulting in constitutive JAK-STAT activation have been detected and associated with BIA-ALCL pathogenesis in a small number of cases. One possible scenario is that an inflammatory microenvironment stimulates a...
Source: The American Journal of Pathology - Category: Pathology Authors: Tags: Am J Pathol Source Type: research