Background:Medical devices used for functional or esthetic purposes improve health and quality of life; however, they are not risk-free. Anaplastic large-cell lymphoma (ALCL), associated with breast implants, is a well-known and recognized distinct lymphoma entity. More recently, additional lymphomas have been reported in relation to prosthesis other than breast implants, as these allow the pericyte to develop into a clone that undergoes a maturation process, progressing toward full malignancy.Methods:We performed a systematic review with a descriptive analysis of data extracted from primary studies following PRISMA guidelines, including the search string “(IMPLANT* OR PROSTHES*) AND LYMPHOM*” in the PubMed, Scopus, Embase, and Google-Scholar databases. Data such as patient sex, age, implant site, prosthesis material, and lymphoma type were analyzed. Statistical methods, including Student’st-test and Fisher’s exact test, were employed to compare lymphoma characteristics, with significance set at ap-value < 0.05.Results:From a total of 5992 studies, we obtained 43 case reports and series on a total of 52 patients diagnosed with prosthesis-associated lymphomas. The majority of implant-related lymphoma cases (85%) were of the B-cell type, mostly fibrin-associated large B-cell lymphoma (LBCL). This lymphoma type was more associated with biological (non-human-derived biological tissue), metallic, and synthetic implants (synthesized from non-organic components) (p-value = 0.007). Patients with ALCL had equal frequencies of metal and silicone prostheses (37.5%, 3 cases each), followed by synthetic prostheses (25%, 2 cases). ALCL cases were most common at skeletal (50%) and muscular-cutaneous sites (25%), whereas B-cell lymphomas were predominantly found in cardiovascular implants (50%), followed by skeletal (27%) and muscular-cutaneous (21%) sites. Death attributed to lymphoma took place in 67% of the cases, mostly LBCL occurring in cardiovascular sites.Conclusions:Because the included studies were limited to case reports and series, a potential non-causal link might have been documented between different implant materials, implant sites and lymphoma types. This underscores the importance of further comprehensive research and monitoring of non-breast implants.
背景：用于功能或美学目的的医疗器械可改善健康和生活质量，但并非全无风险。与乳房植入物相关的间变性大细胞淋巴瘤（ALCL）是一种公认的独特淋巴瘤类型。近期，除乳房植入物外，其他类型假体相关的淋巴瘤病例亦有报道，因假体可使周细胞发育为克隆，经历成熟过程，最终发展为完全恶性病变。 方法：我们遵循PRISMA指南，对原始研究数据进行系统性综述与描述性分析。在PubMed、Scopus、Embase和Google Scholar数据库中采用检索式“(IMPLANT* OR PROSTHES*) AND LYMPHOM*”进行文献检索。分析患者性别、年龄、植入部位、假体材料和淋巴瘤类型等数据。采用Student's t检验和Fisher精确检验等统计方法比较淋巴瘤特征，显著性水平设定为p值<0.05。 结果：从总计5992篇研究中，我们筛选出43篇病例报告及系列研究，共涉及52例假体相关淋巴瘤确诊患者。绝大多数植入物相关淋巴瘤病例（85%）为B细胞型，主要为纤维蛋白相关大B细胞淋巴瘤（LBCL）。该类型淋巴瘤与生物源性（非人源生物组织）、金属及合成材料（非有机成分合成）植入物的关联性更强（p值=0.007）。ALCL患者中金属与硅胶假体使用频率相同（各占37.5%，各3例），其次为合成材料假体（25%，2例）。ALCL病例最常见于骨骼部位（50%）和肌肉皮肤部位（25%），而B细胞淋巴瘤主要出现在心血管植入部位（50%），其次为骨骼（27%）和肌肉皮肤部位（21%）。67%的病例死因与淋巴瘤直接相关，其中多数为发生在心血管部位的LBCL。 结论：由于纳入研究仅限于病例报告和系列研究，不同植入材料、植入部位与淋巴瘤类型之间可能存在非因果性关联。这凸显了对非乳房植入物开展进一步系统研究和长期监测的重要性。
Emerging Non-Breast Implant-Associated Lymphomas: A Systematic Review
肿瘤(癌症)患者之家