Critical Insights From FDG PET CT in Diagnosing Delayed Breast Implant-Associated Anaplastic Large Cell Lymphoma Following Textured Implant Recall

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare T-cell lymphoma strongly associated with textured breast implants. This study presents a case of breast implant-associated anaplastic large cell lymphoma in 58-years-old female patient presented with asymmetrical right breast enlargement after 14 years of texture implant recall. MRI of the right breast showed mild thickening of the fibrous capsule surrounding the implant with diffuse asymmetric enhancement. PET-CT demonstrated a small right peri-implant fluid collection with mild FDG uptake in the superior aspect and a mildly hypermetabolic right axillary lymph node. The breast ultrasound revered fluid collection, and 50 mL of straw-colored fluid was aspirated. Cytology of the fluid revealed abnormal cells positive for CD45, CD30, CD3, but negative for CD20. The Ki-67 proliferation index was 20%, and ALK staining was negative indicating anaplastic large cell lymphoma (BIA-ALCL).