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      Linfoma anaplásico de células grandes asociado a implantes fuera de la mama Translated title: Implant associated-large cell anaplastic lymphoma outside the breast

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          Abstract

          Resumen Introducción y objetivo. El linfoma anaplásico de células grandes asociado a implantes mamarios (LACG-AIM) es una enfermedad poco frecuente y parcialmente comprendida que ha despertado gran interés por el impacto social y económico que genera. Poco se conoce sobre la posible aparición de la enfermedad asociada al uso de implantes en otras localizaciones corporales. El objetivo de este artículo es caracterizar y exponer los casos de pacientes descritos en la literatura con linfoma anaplásico de células grandes asociado a implantes de silicona fuera de la mama. Material y método. Revisión de la literatura en bases de datos Pubmed, Cochrane, ScienceDirect y SciELO buscando reportes de linfoma anaplásico de células grandes asociado a implantes (LACG-AI) en sitios diferentes a la mama. Resultados. Encontramos dos reportes de caso de LACG en glúteos en pacientes con previa gluteoplastia de aumento con implantes realizada con fines estéticos. Llamó la atención el hallazgo de un número mayor de otro tipo de linfomas asociados a la colocación de diferentes dispositivos de uso médico y a la aplicación de biopolimeros glúteos en un caso adicional. Conclusiones. Es posible la existencia de una nueva enfermedad asociada a implantes de silicona en otros sitios corporales. La literatura es escasa y no permite afirmar aun su existencia. Debe tenerse un alto índice de sospecha ante cualquier caso sugerente de la entidad para su estudio, clasificación adecuada y manejo oportuno. Proponemos un algoritmo diagnóstico de utilidad en pacientes portadores de implantes glúteos que presenten alguna sintomatología asociada. Nivel de evidencia científica Diagnóstico 5a

          Translated abstract

          Abstract Background and objective. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare and partially understood disease that has aroused great interest due to the social and economic impact it generates. Little is known about the possible occurrence of the disease associated with the use of implants in other body locations. The objective of this article is to characterize and present the cases of anaplastic large cell lymphoma associated with implants located outside the breast described in the literature. Methods. A review of the literature was performed in PubMed, Cochrane, ScienceDirect and SciELO databases looking for reports of implant-associated anaplastic large cell lymphoma (IA-ALCL) in sites other than the breast. Results. Two case reports of IA-ALCL in the buttocks were found in patients with previous augmentation gluteoplasty with implants performed for aesthetic purposes. Additionally, the finding of a greater number of other types of lymphomas associated with the placement of different devices for medical use and the application of gluteal biopolymers in an additional case. Conclusions. The existence of a new disease associated with silicone implants in other body sites is possible. The literature is scant and does not allow us to confirm its existence. There must be a high index of suspicion in any case suggestive of the entity for its study, proper classification and timely management. We propose a diagnostic algorithm that can be very useful in patients with gluteal implants who present some associated symptoms. Level of evidence Diagnostic 5a

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          Most cited references20

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          2019 NCCN Consensus Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

          National Comprehensive Cancer Network (NCCN) guidelines represent the consensus standard of care for diagnosis and management of the majority of known cancers. NCCN guidelines on breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) have been recognized by the US Food and Drug Administration and widely advocated by national specialty societies. Consensus guidelines have helped create a treatment standardization for BIA-ALCL at all stages of disease. NCCN guidelines are evidence-based where possible and utilize expert consensus opinion to fill in gaps that may exist. NCCN undergoes annual panel review by multidisciplinary faculty members, and this article represents the most up-to-date 2019 guidelines. Recommendations focus on parameters for achieving reliable diagnosis and disease management and emphasize the critical role for complete surgical ablation. Suggestions for adjunct treatments and chemotherapy regimens are included for advanced BIA-ALCL with lymph node involvement. BIA-ALCL recurrence and management of unresectable disease, and organ metastasis are addressed. Adherence to recognized BIA-ALCL guidelines ensures patients receive the most current efficacious treatment available.
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            Current Risk Estimate of Breast Implant–Associated Anaplastic Large Cell Lymphoma in Textured Breast Implants

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              Silicone implants and lymphoma: The role of inflammation.

              The risk of hematological malignancies is mainly determined by genetic background, age, sex, race and ethnicity, geographic location, exposure to certain chemicals and radiation; along with the more recently proposed immune factors such as chronic inflammation, immunodeficiencies, autoimmunity, and infections. Paradigmatic examples include the development of lymphoma in Sjögren's syndrome and Hashimoto thyroiditis, gastric MALT lymphoma in Helicobacter pylori infection, or lymphomas associated with infections by Epstein-Barr virus, human herpes virus 8 (HHV 8) and leukemia/lymphoma virus 1 (HTLV-1). A growing number of reports indicates an increased risk of lymphoma, particularly of the anaplastic large cell (ALCL) type. The implants, specifically those used in the past, elicit chronic stimulation of the immune system against the prosthetic material. This is particularly the case in genetically susceptible hosts. We suggest that polyclonal activation may result in monoclonality in those at risk hosts, ultimately leading to lymphoma. We suggest that patients with an inflammatory response against silicone implants be monitored carefully.
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                Author and article information

                Journal
                cpil
                Cirugía Plástica Ibero-Latinoamericana
                Cir. plást. iberolatinoam.
                Sociedad Española de Cirugía Plástica, Reparadora y Estética (SECPRE) (Madrid, Madrid, Spain )
                0376-7892
                1989-2055
                March 2023
                : 49
                : 1
                : 17-24
                Affiliations
                [1] Cali Valle del Cauca orgnameUniversidad del Valle Colombia
                Article
                S0376-78922023000100004 S0376-7892(23)04900100004
                10.4321/s0376-78922023000100004
                1bc6b60d-fbc9-4bcf-9741-fcb837647936

                This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

                History
                : 21 September 2022
                : 08 February 2023
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 20, Pages: 8
                Product

                SciELO Spain

                Categories
                Tema Especial

                Silicone implants,Dispositivos médicos,Prótesis,Elastómeros de silicona,Implantes silicona,Linfoma,Linfoma anaplásico de células grandes,Medical devices,Prosthesis,Silicone elastomers,Lymphoma,Anaplastic large cell lymphoma

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