43-year-old mestizo female with a history of augmentation mammoplasty performed in June 2009: periareolar incision, transglandular dissection, subfascial pocket, California Medical Corporation.
The same intervention also underwent abdominoplasty and liposuction of the lower back area.
Aspiration drains were placed and removed 24 hours after surgery.
The postoperative course was uneventful and the result was satisfactory.
One year after the procedure, the patient developed right breast discomfort and edema, which resolved with nonsteroidal anti-inflammatory drugs at doses of 120 mg per day for 7 days.
The subsequent evolution was achieved by 2015: 5 years after the symptoms and 6 years after the intervention, when the patient again presented with right breast discomfort and edema, as well as satisfactory appearance of these discomforts.
Magnetic resonance imaging (MRI) revealed abundant periprocedural fluid in the affected breast.
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In view of the situation, ultrasound guided puncture was performed obtaining 270 cc of serous material, without detritus inside, dark yellow and without characteristic odor.
A sample was sent for cytological study that reported chronic constipation with granulomatous reaction and negative culture.
However, the paulatine increase of the breast continued in the following months, performing 2 new punctures without success.
In the second puncture fluid was sent again for malignancy study when a possible ductal carcinoma was suspected.
The patient was evaluated again by means of imaging studies by ultrasound and MRI without finding abnormalities in the breast parenchyma, so we decided to remove the implant with capsulectomy and transoperative breast tissue review.
The surgery was performed in conjunction with an oncologist surgeon who reviewed the mammary gland and took samples from different quadrants.
The transoperative and definitive study of both sent breast tissue and periprosthetic capsule was negative for malignancy.
However, the periprocedural fluid evacuated during surgery was positive for leukocytes in the cytological study.
This fluid was also studied by elaboration of cellular block and implanted with histological and immunohistochemical techniques.
The latter obtained a positive result for GLA, T immunophenotype, positive for CD 45, CD3, CD 30 and EMA (anticipated epithelial membrane, a proliferation), negative for CKAE1/AEpl3 (cytokeratin),
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The Hematology Department proposed the performance of positron emission tomography (PET) study, however the patient decided not to continue staging studies despite the final diagnosis of lymphoma date, and did not even reject the contralateral implant until the final diagnosis.
At present, the 2016 edition is asymptomatic.
