Fig. 3: EBV+ large B-cell lymphoma, not otherwise specified, arising in a patient with breast implants.

A Lymphohistiocytic infiltrate around a breast implant that the patient referred to as a nodule. The infiltrate involves fibrous capsule (top right) that displays sclerosis and inflammatory cells. The infiltrate permeates into surrounding breast ducts (bottom left). Hematoxylin and eosin, 200×. B Detail of the infiltrate as noted at initial presentation. The infiltrate in both the capsule as well as around breast ducts was similar and was composed of occasional large hyperchromatic cells with lobated nuclei and distinct nucleoli admixed with numerous small lymphocytes, histiocytes, and scattered eosinophils with a highly sclerotic background. This infiltrate was initially misinterpreted as reactive. C Immunohistochemistry of the tumor mass demonstrates that the neoplastic cells are positive for CD30, with cytoplasmic and faint membrane reactivity. Immunohistochemistry with hematoxylin counterstain, 400×. D Axillary lymph node at relapse, 2 years after initial presentation. There is a diffuse infiltrate composed of large cells with vesicular chromatin and distinct nucleolus, admixed with eosinophils. Hematoxylin and eosin, 400×.