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유방보형물 연관 역형성대세포림프종의 국내 현황

Current status of breast implant-associated anaplastic large cell lymphoma in South Korea

대한의사협회지 2021년 64권 1호 p.5 ~ 9
윤을식,
소속 상세정보
윤을식 ( Yoon Eul-Sik ) - Korea University College of Medicine Korea University Anam Hospital Department of Plastic and Reconstructive Surgery

Abstract


Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a unique type of lymphoma caused by breast implants. Concerns about BIA-ALCL have increased worldwide, and three domestic cases have been reported in South Korea. However, the incidence of the disease is not clear, and the risk probability has been reported to be up to 1/3,000. The most important factor in BIA-ALCL is the texturing of the implanted devices. Since the type of texturing is heterogeneous among products and companies, it is important for physicians to be aware of the spectrum of products and their implied risk. The pathophysiology of BIA-ALCL is presumed to be a combination of chronic inflammation related to the microenvironment and genetic predisposition. Further studies will allow accurate diagnosis and prognosis of the disease. The prognosis of BIA-ALCL is favorable if patients with late seroma or pericapsular masses are diagnosed early and complete surgical removal is achieved. Accurate diagnosis includes cytology or pathology with immunohistochemistry, including the CD30 protein and anaplastic lymphoma kinase. An essential factor in surgical success is radical excision with total capsulectomy. However, there is no evidence for prophylactic removal of a textured implant without symptoms. Careful examination and consultation should precede the implant removal, which can lead to deformity or complications. Domestic collaboration among healthcare providers for diagnosis and treatment is needed along with active reporting and registration of suspected patients. Finally, worldwide cooperation and improved awareness leading to regular surveillance are crucial in the era of BIA-ALCL.

키워드

유방보형물; 역행성큰세포림프종; 병태생리학; 예후; 치료
Breast implants; Anaplastic large cell lymphoma; Pathophysiology; Prognosis; Treatment

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