Fig. 1

Pathologic staging of capsulectomies in patients with breast implant anaplastic large cell lymphoma. a Left: Cytologic smear of effusion displays large pleomorphic cells with abundant basophilic cytoplasm containing vacuoles. Wright Giemsa stain, ×500. Right: Cell block of effusion displays large pleomorphic cells with a fibrinoid background. Hematoxylin and eosin stain, ×400. b Luminal side of capsule devoid of lymphoma cells (stage T0); the diagnosis in this case was based on positive cytology in the effusion. (Left: Hematoxylin and eosin, ×200; Right: CD30 immunohistochemistry, ×200). c Representative section of capsule involved by breast implant anaplastic large cell lymphoma displays the entire luminal surface has anaplastic large cell lymphoma cells, consistent with excellent orientation and proper “on edge” embedding (stage T1) (left). The neoplastic cells are admixed with abundant granular and necrotic material representing karyorrhectic tumor, further confirmed with CD30 immunohistochemistry (Left. hematoxylin and eosin, ×200; Right. CD30 immunohistochemistry with hematoxylin counterstain, ×200). d The lymphoma cells involve the luminal side of the capsule (stage T2) in which tumor cells infiltrate superficially into the capsule. (Left: hematoxylin and eosin, ×400; Right: CD30 immunohistochemistry, ×400). e The lymphoma cells infiltrate deep into the capsule (stage T3) in which lymphoma cells are admixed with reactive inflammatory cells. (Left: hematoxylin and eosin, ×200; Right: CD30 immunohistochemistry, ×200). f In this low magnification, the lymphoma cells extend beyond the capsule (T4) in which tumor cells form large clusters throughout the capsule. (Left: hematoxylin and eosin, ×40; Right: CD30 immunohistochemistry, ×40)