MRI Case 6

60 y/o F presents for diagnostic MRI to evaluate implants. Patient has a history of left breast cancer s/p bilateral mastectomy and reconstruction. What is the most likely diagnosis?

MALIGNANT PERI-IMPLANT EFFUSION

  • High T2 signal contained within the fibrous capsule and surrounding the internal capsule
  • On silicone suppressed sagittal image, the surrounding fluid remains bright 
  • Note: A mass is present at the posterior aspect of the fibrous capsule
  • Important for differential – RULE OUT: Breast-Implant Associated Anaplastic Large Cell Lymphoma (ALCL)

Related Radiology Article: Sharma B, Jurgensen-Rauch A, Pace E, Attygalle AD, Sharma R, Bommier C, Wotherspoon AC, Sharma S, Iyengar S, El-Sharkawi D. Breast implant–associated anaplastic large cell lymphoma: review and multiparametric imaging paradigms. Radiographics. 2020 May;40(3):609-28.