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array:24 [ "pii" => "S2173510720300434" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2020.01.010" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "1185" "copyright" => "SERAM" "copyrightAnyo" => "2020" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2020;62:266-79" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S003383382030031X" "issn" => "00338338" "doi" => "10.1016/j.rx.2020.01.008" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "1185" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2020;62:266-79" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Actualización</span>" "titulo" => "Complicaciones infrecuentes de las prótesis de mama" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "266" "paginaFinal" => "279" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Uncommon complications of breast prostheses" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figura 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2647 "Ancho" => 2508 "Tamanyo" => 440726 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Seroma tardío. A) Mamografía craneocaudal de mama derecha que muestra discreto aumento de densidad adyacente a la vertiente interna de la prótesis, sin alteración de su contorno (flecha). B) En ecografía corresponde a pequeña cantidad de líquido anecogénico (*). C) Resonancia magnética axial STIR, D) Sagital T1 tras administración de contraste intravenoso. Pequeño seroma periprotésico (*) con integridad del implante. Asocia discreto realce difuso de la cápsula fibrosa (flecha). Se realizó punción aspirativa con aguja fina evacuadora del líquido periprotésico y no se logró identificar ninguna causa (seroma idiopático).</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "N. Sánchez Rubio, B. Lannegrand Menéndez, M. Duque Muñoz, M. Montes Fernández, M.J. Ciudad Fernández" "autores" => array:5 [ 0 => array:2 [ "nombre" => "N." "apellidos" => "Sánchez Rubio" ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Lannegrand Menéndez" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Duque Muñoz" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Montes Fernández" ] 4 => array:2 [ "nombre" => "M.J." "apellidos" => "Ciudad Fernández" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173510720300434" "doi" => "10.1016/j.rxeng.2020.01.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510720300434?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003383382030031X?idApp=UINPBA00004N" "url" => "/00338338/0000006200000004/v2_202009020809/S003383382030031X/v2_202009020809/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173510720300483" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2020.01.011" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "1187" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2020;62:280-91" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Update in Radiology</span>" "titulo" => "Aortoenteric fistulas: Spectrum of MDCT findings" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "280" "paginaFinal" => "291" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Fístula aortoentérica: Espectro de hallazgos en tomografía computarizada multidetector" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 1641 "Ancho" => 1850 "Tamanyo" => 195179 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Secondary aortoenteric fistula in a 78-year-old male with a history of aortobifemoral bypass surgery and peptic ulcer disease who sought care due to signs and symptoms of upper gastrointestinal bleeding. Endoscopy revealed an ulceration of the intestinal wall with direct observation of the bypass material. In view of the patient's haemodynamic stability it was decided to assess him by computed tomography. Arterial phase (A), portal phase (B) and MIP reconstruction on the sagittal plane (C). The aortobifemoral bypass was seen to be in intimate contact with the retroperitoneal duodenum presenting a soft-tissue sleeve surrounding the bypass (*) and an ectopic air bubble (arrow tip) with no fat plane for separation. Although active extravasation of IVC was not demonstrated, surgery confirmed the presence of an AEF.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Nagrani Chellaram, E. Martínez Chamorro, S. Borruel Nacenta, L. Ibáñez Sanz, A. Alcalá-Galiano" "autores" => array:5 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Nagrani Chellaram" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Martínez Chamorro" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Borruel Nacenta" ] 3 => array:2 [ "nombre" => "L." "apellidos" => "Ibáñez Sanz" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Alcalá-Galiano" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0033833820300333" "doi" => "10.1016/j.rx.2020.01.010" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833820300333?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510720300483?idApp=UINPBA00004N" "url" => "/21735107/0000006200000004/v2_202009020633/S2173510720300483/v2_202009020633/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2173510720300422" "issn" => "21735107" "doi" => "10.1016/j.rxeng.2020.01.009" "estado" => "S300" "fechaPublicacion" => "2020-07-01" "aid" => "1184" "copyright" => "SERAM" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Radiologia. 2020;62:252-65" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Update in Radiology</span>" "titulo" => "Screening in patients with increased risk of breast cancer (part 1): Pros and cons of MRI screening" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "252" "paginaFinal" => "265" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Cribado en pacientes con riesgo incrementado de cáncer de mama (parte 1). Pros y contras del cribado con resonancia magnética" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 811 "Ancho" => 1074 "Tamanyo" => 100561 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A 38-year-old patient with familial HR went in for her first round of annual screening with MRI and MG (she had been classified as a patient at HR as her family history had been identified in genetic counselling). MG: dense breast “ACR D” (not shown) with no findings. MRI with intravenous contrast: early axial MIP reconstruction (“a”), early sagittal MIP reconstruction of the right breast (“b”) and of the left breast (“c”), and delayed 3D axial images with fat saturation of the left breast (“d”) are shown: a prepectoral circumscribed nodular enhancement in the upper inner quadrant of the left breast close to the upper interquadrants, measuring around 6–7<span class="elsevierStyleHsp" style=""></span>mm (circle); a type 3 enhancement curve (“e”); and a post-MRI ultrasound (“f”) corresponding to a circumscribed isoechoic/slightly hypoechoic solid nodule measuring around 6.7<span class="elsevierStyleHsp" style=""></span>mm (circle) are seen. This was considered a suspicious finding. An (ultrasound-guided) post-MRI core-needle biopsy was performed with the following result: <span class="elsevierStyleItalic">grade I infiltrating ductal carcinoma + DCIS</span>. Molecular subtype: luminal B, HER 2+. The sentinel lymph node biopsy was negative.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "S. Alonso Roca, A.B. Delgado Laguna, J. Arantzeta Lexarreta, B. Cajal Campo, S. Santamaría Jareño" "autores" => array:5 [ 0 => array:2 [ "nombre" => "S." "apellidos" => "Alonso Roca" ] 1 => array:2 [ "nombre" => "A.B." "apellidos" => "Delgado Laguna" ] 2 => array:2 [ "nombre" => "J." "apellidos" => "Arantzeta Lexarreta" ] 3 => array:2 [ "nombre" => "B." "apellidos" => "Cajal Campo" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Santamaría Jareño" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0033833820300308" "doi" => "10.1016/j.rx.2020.01.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0033833820300308?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510720300422?idApp=UINPBA00004N" "url" => "/21735107/0000006200000004/v2_202009020633/S2173510720300422/v2_202009020633/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Update in Radiology</span>" "titulo" => "Uncommon complications of breast prostheses" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "266" "paginaFinal" => "279" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "N. Sánchez Rubio, B. Lannegrand Menéndez, M. Duque Muñoz, M. Montes Fernández, M.J. Ciudad Fernández" "autores" => array:5 [ 0 => array:4 [ "nombre" => "N." "apellidos" => "Sánchez Rubio" "email" => array:1 [ 0 => "nsrnansaru@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "B." "apellidos" => "Lannegrand Menéndez" ] 2 => array:2 [ "nombre" => "M." "apellidos" => "Duque Muñoz" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Montes Fernández" ] 4 => array:2 [ "nombre" => "M.J." "apellidos" => "Ciudad Fernández" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Radiodiagnóstico, Hospital Clínico Universitario San Carlos, Madrid, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Complicaciones infrecuentes de las prótesis de mama" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0035" "etiqueta" => "Figure 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 1660 "Ancho" => 2508 "Tamanyo" => 418789 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Breast fibromatosis (same case as in <a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>). (A) Axial T1. A large isointense mass, located in close contact with and posterior to the right implant with anterior displacement of the prosthesis and a significant increase in breast volume. The split fat sign, consisting of a fine halo of fat surrounding the lesion, was identified (white arrow). (B) Sagittal T2 showing the hyperintense mass with small hypointense areas inside the lesion (orange arrow). (C and D) MRI following administration of intravenous contrast. The mass presented significant contrast uptake with the presence of small hypointense areas (orange arrow) corresponding to the presence of collagen fibres with limited cellularity. It presented local infiltration with spread through the intercostal space towards the thorax (white arrow). (E and F) Perfusion map and kinetic curve showing increased perfusion with a plateau (type 2) kinetic curve.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Breast implants are among the most commonly used medical devices, either for aesthetic reasons or for breast reconstruction following breast cancer surgery. The prostheses consist of a silicone covering or coverings filled with saline solution, silicone gel or both. The surface of the implant may be smooth or textured, and the shape may be rounded or anatomical. Depending on their site of placement, they may be retroglandular or retropectoral.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1–4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The complications associated with breast implants may be classified as early, when they occur in the post-operative period, or late, when they occur months or years following the operation. The main early complications include infection and periprosthetic collections, and the main late complications include rupture and capsular contracture.<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">1</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">Recently, more uncommon late adverse effects have been reported, some of greater significance, such as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), breast fibromatosis associated with implants, formation of granulomas secondary to silicone in the fibrous capsule, and lymphadenopathy in patients with implants, which in certain cases may represent a diagnostic dilemma.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Common complications associated with breast implants have been widely studied and are known to all radiologists. This article conducts a review of uncommon pathology associated with breast implants, with a focus on radiological findings and on the clinical and radiological management of said pathology for a proper differential diagnosis (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>). Predictably, the prevalence of these complications will increase as a result of increased use of breast implants; therefore, knowledge and suitable management thereof are important.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0030">Late infection</span><p id="par0025" class="elsevierStylePara elsevierViewall">Infections in the recent post-operative period are among the most common complications, with an incidence of approximately 1.7%. However, late infections (months or years following surgery) are an uncommon complication with an incidence of approximately 0.8% and are usually secondary to a systemic infection.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,5–7</span></a></p><p id="par0030" class="elsevierStylePara elsevierViewall">The incidence of infection is even greater in patients with post-mastectomy reconstruction, mainly with immediate reconstruction.<a class="elsevierStyleCrossRefs" href="#bib0285"><span class="elsevierStyleSup">5,8</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">It usually presents with fever, pain, erythema and inflammation. The most commonly found pathogens are those located on the skin surface, such as <span class="elsevierStyleItalic">Staphylococcus aureus</span>.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,5,8</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">If there is no improvement with antibiotic treatment, explantation is recommended. Explantation is also recommended in cases of fungal infection or if there are signs of systemic infection.<a class="elsevierStyleCrossRef" href="#bib0265"><span class="elsevierStyleSup">1</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">Hypoechoic collections that may have echogenic content are found on ultrasound. Ultrasound serves as a guide for percutaneous fluid aspiration, which allows for cytology testing, immunohistochemistry testing and culture for a proper differential diagnosis.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Radiological findings on magnetic resonance imaging (MRI) are the presence of a periprosthetic collection, breast oedema and skin thickening<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,5,7–9</span></a> (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Lymphadenopathy</span><p id="par0055" class="elsevierStylePara elsevierViewall">Normally, 75% of lymphatic drainage of the breast occurs through the homolateral axillary lymph nodes, and the other 25% occurs through the internal mammary chain lymph nodes, the contralateral breast and the inferior phrenic lymph nodes. This drainage may become abnormal following lymphadenectomy or sentinel lymph node biopsy.<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">10</span></a></p><p id="par0060" class="elsevierStylePara elsevierViewall">In patients with breast reconstruction with prostheses, enlarged lymph nodes secondary to a non-specific inflammatory reaction or a reaction to a foreign body due to migration of silicone to the lymph nodes may be found in the axillary region or in the internal mammary lymph node chains. It usually occurs six to ten years following implantation.<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">4,10,11</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">These lymphadenopathies may present intense fluorodeoxyglucose uptake on positron emission tomography/computed tomography (PET/CT) and therefore represent a diagnostic dilemma in patients with a history of cancer<a class="elsevierStyleCrossRefs" href="#bib0280"><span class="elsevierStyleSup">4,10</span></a> (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Some studies have reported percentages of lymphadenopathy in the internal mammary lymph node chains close to 30% in patients with breast surgery and reconstruction with prostheses, some with uptake on PET/CT, although with very low positive predictive values for malignancy; therefore, in the absence of other data arousing suspicion of relapse, it might be managed conservatively by means of radiological follow-up.<a class="elsevierStyleCrossRef" href="#bib0310"><span class="elsevierStyleSup">10</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Late seroma</span><p id="par0075" class="elsevierStylePara elsevierViewall">Late seroma is a rare complication, defined as any periprosthetic collection that occurs after the year following surgery. Its exact incidence is unknown, although approximate figures of 0.5%–1.84% are reported, and it is most commonly associated with textured and polyurethane implants.<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">12–15</span></a></p><p id="par0080" class="elsevierStylePara elsevierViewall">Its pathophysiology is unknown. It may include mechanical factors such as trauma and synovial metaplasia secondary to microtrauma, and non-mechanical factors such as clinical and subclinical infection, inflammation and lymphoproliferative processes.<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">12,16</span></a> However, in most cases, no cause is found; these are deemed idiopathic.<a class="elsevierStyleCrossRef" href="#bib0330"><span class="elsevierStyleSup">14</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">On ultrasound and MRI it presents as a periprosthetic collection that may be associated with fibrous capsule thickening (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">It is necessary to rule out infection and malignancy by means of ultrasound-guided aspiration of the periprosthetic fluid, which should be sent for culture and cytology in which cell composition, cell morphology and percentage of CD30+ cells are assessed.<a class="elsevierStyleCrossRefs" href="#bib0335"><span class="elsevierStyleSup">15–17</span></a></p><p id="par0095" class="elsevierStylePara elsevierViewall">Treatment is conservative, and even if cultures are negative, the possibility of subclinical infection should be considered. If a seroma is resistant to treatment, explantation of the prostheses and capsulectomy are recommended.<a class="elsevierStyleCrossRefs" href="#bib0320"><span class="elsevierStyleSup">12,15,16</span></a></p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Silicone-induced granulomas</span><p id="par0100" class="elsevierStylePara elsevierViewall">One recently reported complication is formation of masses on the periprosthetic fibrous capsule in patients with intact implants as a result of an inflammatory response to silicone.</p><p id="par0105" class="elsevierStylePara elsevierViewall">All types of implants, even the most modern, have demonstrated filtration of silicone particles that, when they come into contact with the fibrous capsule, induce a type 2 inflammatory response with increased IgE and IgG levels<span class="elsevierStyleInf">1</span> and chronic activation of T lymphocytes with consequent granuloma formation.<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">18,19</span></a> This immune response will be mild when there is a predominance of giant cells and more aggressive when there is a greater lymphocyte component.<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">18</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">The intracapsular space has limited vascularisation; therefore, in early phases, when the fibrous capsule is intact, the granuloma is found to be located in the intracapsular space and this is a limited condition with a good prognosis.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Extracapsular granuloma occurs when the mass invades the fibrous capsule and spreads to the adjacent tissue. Exposure to the intracapsular content may cause a more striking – even systemic – immune reaction, with the possibility of finding regional lymphadenopathy with silicone infiltration.<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">18,20</span></a></p><p id="par0120" class="elsevierStylePara elsevierViewall">Clinically, granulomas present with signs of capsular contracture such as stiffness and pain in the affected breast. As associated findings, patients may present arthralgia, pruritus and asthenia, commonly reported symptoms in the autoimmune syndrome induced by adjuvants such as silicone.<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">18–22</span></a> In addition, there may be periods of spontaneous remission or remission with anti-inflammatory agents/corticosteroids.<a class="elsevierStyleCrossRef" href="#bib0350"><span class="elsevierStyleSup">18</span></a></p><p id="par0125" class="elsevierStylePara elsevierViewall">Granulomas may be associated with a haematoma or intracapsular seroma, enhancement of the fibrous capsule to different degrees or capsular contracture.</p><p id="par0130" class="elsevierStylePara elsevierViewall">Prevalences of intracapsular granulomas of 27% have been reported; of these, 12% were associated with a seroma and 3% showed signs of extracapsular involvement.<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">20</span></a></p><p id="par0135" class="elsevierStylePara elsevierViewall">Histologically, they are formed by extracellular or intracellular silicone, histiocytes, chronic granulomatous inflammatory infiltrate with multi-nucleated giant cells and mixed lymphocytic infiltrate with no atypia<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">20</span></a> (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">Radiological findings of intracapsular granuloma:<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">•</span><p id="par0145" class="elsevierStylePara elsevierViewall">A heterogeneous intracapsular mass may be visualised on ultrasound; this may be associated with snowstorm artefact due to free silicone.<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">20</span></a></p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">•</span><p id="par0150" class="elsevierStylePara elsevierViewall">MRI is the best diagnostic technique for its assessment, since it also assesses implant integrity.</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">•</span><p id="par0155" class="elsevierStylePara elsevierViewall">The intracapsular mass shows a hypersignal in T2-enhanced sequences and a hyposignal in T1-enhanced sequences. It may exert a mass effect on the implant<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">18–20,23</span></a> (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">•</span><p id="par0160" class="elsevierStylePara elsevierViewall">Late dynamic sequences (more than 4<span class="elsevierStyleHsp" style=""></span>min) must be performed following administration of intravenous contrast in order to distinguish between intracapsular seroma/haematoma.<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">18,23</span></a> It will present gradual enhancement with type I curves, sometimes with hypervascular nodular areas inside the mass.</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">•</span><p id="par0165" class="elsevierStylePara elsevierViewall">The black-drop sign may be identified; this consists of a focus of marked hyposignal at the interface between the implant covering and the granuloma in the dynamic study.<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">18,20</span></a></p></li><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">•</span><p id="par0170" class="elsevierStylePara elsevierViewall">PET/CT is usually negative<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">20</span></a> (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p></li></ul></p><p id="par0175" class="elsevierStylePara elsevierViewall">Radiological findings of extracapsular granuloma:<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">•</span><p id="par0180" class="elsevierStylePara elsevierViewall">A mass with peripheral vascularisation and areas with snowstorm artefact may be identified on ultrasound<a class="elsevierStyleCrossRefs" href="#bib0360"><span class="elsevierStyleSup">20,23</span></a> (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>).</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">•</span><p id="par0185" class="elsevierStylePara elsevierViewall">A mass with infiltration of the fibrous capsule will be visualised on MRI. Following administration of intravenous contrast, due to the lack of barrier represented by the fibrous capsule, it may present enhancement in early phases. There may be axillary siliconomas<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">20</span></a> (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>).</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">•</span><p id="par0190" class="elsevierStylePara elsevierViewall">Uptake by the mass as well as uptake by the axillary and mammary lymph nodes may be identified on PET/CT.<a class="elsevierStyleCrossRef" href="#bib0360"><span class="elsevierStyleSup">20</span></a></p></li></ul></p><p id="par0195" class="elsevierStylePara elsevierViewall">The differential diagnosis of granulomas includes mainly seroma and late haematoma, for which administration of intravenous contrast will be necessary, as well as BIA-ALCL, which in a third of cases may present as a periprosthetic mass.<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">18–20,23</span></a></p><p id="par0200" class="elsevierStylePara elsevierViewall">Treatment consists of prosthesis explantation and capsulectomy.<a class="elsevierStyleCrossRefs" href="#bib0350"><span class="elsevierStyleSup">18,20</span></a></p><p id="par0205" class="elsevierStylePara elsevierViewall">It is advisable to avoid percutaneous biopsies when an intracapsular granuloma is suspected due to the risk of rupture of the barrier that provides the fibrous capsule which could lead to a systemic reaction.<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">19,23</span></a></p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Breast fibromatosis</span><p id="par0210" class="elsevierStylePara elsevierViewall">Desmoid tumours or fibromatoses comprise a rare type of benign stromal tumour that may be classified based on their location as extra-abdominal, abdominal or intra-abdominal.<a class="elsevierStyleCrossRefs" href="#bib0380"><span class="elsevierStyleSup">24–26</span></a> Breast fibromatosis is an extremely uncommon disease accounting for approximately 4% of extra-abdominal desmoid tumours and 0.2% of all breast tumours.<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">27–30</span></a> Cases associated with breast implants are even rarer, with few published studies in the specialised literature.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,31,32</span></a></p><p id="par0215" class="elsevierStylePara elsevierViewall">Breast fibromatosis may originate in the breast parenchyma, the aponeurosis of the pectoral muscle and probably in the periprosthetic capsule.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,27–29</span></a></p><p id="par0220" class="elsevierStylePara elsevierViewall">They present infiltrative and aggressive local growth with a high percentage of relapse, but not a tendency to metastasise.<a class="elsevierStyleCrossRef" href="#bib0395"><span class="elsevierStyleSup">27</span></a> Due to this growth, they may simulate malignancy, especially in patients with a history of prior breast surgery.<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">27,28</span></a></p><p id="par0225" class="elsevierStylePara elsevierViewall">Their pathogenesis is unknown. However, most desmoid tumours occur sporadically, being associated in up to 85% of these cases with a mutation in the beta-catenin gene.<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">31</span></a> Cases associated with Gardner syndrome, trauma, surgery or augmentation mammoplasty have been reported.<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">25,26,31</span></a> Increased tumour volume has been observed during pregnancy, suggesting a hormonal, mainly oestrogenic, influence.<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">25,26,32</span></a></p><p id="par0230" class="elsevierStylePara elsevierViewall">It was recently suggested that the presence of breast implants may be a risk factor, although a clear causal relationship has not yet been confirmed.<a class="elsevierStyleCrossRef" href="#bib0405"><span class="elsevierStyleSup">29</span></a> More cases have been reported in association with silicone implants versus saline implants, although this may be due to the greater prevalence of silicone implants.<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">27,28</span></a> Most cases have occurred two to three years after surgery, and in all reported cases the implants were found to be intact.<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">27,28</span></a></p><p id="par0235" class="elsevierStylePara elsevierViewall">Clinically, they usually present as a single, firm and painless palpable mass with rapid growth.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,28,32</span></a></p><p id="par0240" class="elsevierStylePara elsevierViewall">Histologically, they are composed of small groups of spindle-shaped cells and fibroblasts separated by variable amounts of collagen.<a class="elsevierStyleCrossRefs" href="#bib0390"><span class="elsevierStyleSup">26,28</span></a> They usually present nuclear positivity for beta-catenin and negativity for oestrogen and progesterone receptors.<a class="elsevierStyleCrossRefs" href="#bib0400"><span class="elsevierStyleSup">28,30</span></a></p><p id="par0245" class="elsevierStylePara elsevierViewall">Radiological findings are non-specific; therefore, a biopsy must be performed to diagnose them.</p><p id="par0250" class="elsevierStylePara elsevierViewall">Breast fibromatosis presents an appearance provoking suspicion of malignancy on both mammography and ultrasound. However, cases associated with breast implants usually show a more benign appearance, with relatively well-defined margins despite their tendency towards local infiltration<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,27,28</span></a> (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>).</p><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0255" class="elsevierStylePara elsevierViewall">MRI is the imaging technique of choice to evaluate both tumour spread and the relationship of the tumour to adjacent structures.<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">25,27,31,33,34</span></a> Masses are observed which may present well-defined margins (49%–54%) or irregular and infiltrative margins (46%–51%).<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">31</span></a></p><p id="par0260" class="elsevierStylePara elsevierViewall">Lesion signal and enhancement kinetics vary by amount of collagen and degree of cellularity.<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">25,27,31</span></a> Three histological stages are reported depending on collagen content and cellularity which influence the signal in T2-enhanced sequences. In initial stages, they present a lesser amount of collagen and greater cellularity, which translates to high signal in T2, as well as lesser cellularity and a greater amount of collagen in end stages with low signal in T2-enhanced sequences.<a class="elsevierStyleCrossRef" href="#bib0415"><span class="elsevierStyleSup">31</span></a> They often present gradual kinetics, although cases of plateau or washout kinetics in late phases have also been reported<a class="elsevierStyleCrossRefs" href="#bib0385"><span class="elsevierStyleSup">25,27,28,34</span></a> (<a class="elsevierStyleCrossRef" href="#fig0035">Fig. 7</a>).</p><elsevierMultimedia ident="fig0035"></elsevierMultimedia><p id="par0265" class="elsevierStylePara elsevierViewall">Fibromatoses usually show in 62%–91% hypointense areas inside the lesion in all sequences due to the presence of collagen fibres with limited cellularity<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">27,31</span></a> (<a class="elsevierStyleCrossRef" href="#fig0035">Fig. 7</a>).</p><p id="par0270" class="elsevierStylePara elsevierViewall">Other signs that may be visualised on different imaging techniques, although essentially on MRI, are the fascial tail sign, which consists of linear extensions across the fascial planes, and the split-fat sign, which consists of a fine halo of fat surrounding the lesion<a class="elsevierStyleCrossRefs" href="#bib0395"><span class="elsevierStyleSup">27,31,35</span></a> (<a class="elsevierStyleCrossRefs" href="#fig0035">Figs. 7 and 8</a>).</p><elsevierMultimedia ident="fig0040"></elsevierMultimedia><p id="par0275" class="elsevierStylePara elsevierViewall">PET/CT may aid in guiding the biopsy, evaluating the aggressiveness of the lesion and diagnosing disease recurrences and progression.<a class="elsevierStyleCrossRefs" href="#bib0440"><span class="elsevierStyleSup">36–38</span></a> Desmoid tumours are usually hypermetabolic, although there may be intralesional variability depending on the percentage of cells and the collagen content of the lesion<a class="elsevierStyleCrossRefs" href="#bib0445"><span class="elsevierStyleSup">37,38</span></a> (<a class="elsevierStyleCrossRef" href="#fig0040">Fig. 8</a>).</p><p id="par0280" class="elsevierStylePara elsevierViewall">Management and treatment of these lesions is debated due to the few existing cases. Whenever possible, the treatment of choice will consist of wide local excision with negative margins in an attempt to decease their recurrence.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,26,28</span></a> Radiotherapy is usually the treatment pursued when the disease is unresectable or associated with surgery if negative margins cannot be achieved.<a class="elsevierStyleCrossRefs" href="#bib0390"><span class="elsevierStyleSup">26,28</span></a></p><p id="par0285" class="elsevierStylePara elsevierViewall">Drug treatment is usually reserved for patients with recurrences and includes non-steroidal anti-inflammatory drugs, interferon, hormone therapy and cytotoxic agents with different degrees of success.<a class="elsevierStyleCrossRef" href="#bib0420"><span class="elsevierStyleSup">32</span></a> Although desmoid tumours usually do not express oestrogen receptors, anti-oestrogenic agents (tamoxifen) have demonstrated disease management in some cases (from disease stabilisation to cases of complete remission).<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">26</span></a> Tamoxifen's mechanism of action is not clear, but it appears to be independent of oestrogen receptor expression.<a class="elsevierStyleCrossRef" href="#bib0390"><span class="elsevierStyleSup">26</span></a></p><p id="par0290" class="elsevierStylePara elsevierViewall">Clinical and radiological follow-up are necessary due to the high rate of relapse, especially in the first three years.<a class="elsevierStyleCrossRef" href="#bib0455"><span class="elsevierStyleSup">39</span></a></p></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Anaplastic large cell lymphoma</span><p id="par0295" class="elsevierStylePara elsevierViewall">Primary breast lymphoma (PBL) is a rare tumour accounting for 0.5% of cases of breast cancer and 2% of cases of extranodal lymphoma. PBL originates in the periductal and perilobar breast lymphoid tissue. Most PBLs derive from B cells; tumours with T cell phenotypes are rare (less than 6%).<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">19</span></a></p><p id="par0300" class="elsevierStylePara elsevierViewall">Anaplastic large cell lymphoma is a peripheral T cell lymphoma that accounts for 2%–3% of all non-Hodgkin lymphomas.<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">19,40,41</span></a> It may affect a wide variety of tissues, including breast tissue. There are two variants of anaplastic large cell lymphoma: one is systemic, with lymphadenopathy and extranodal involvement; the other is cutaneous. In 2016, the World Health Organization (WHO) recognised BIA-ALCL as a discrete entity, diagnosed in the capsule or the periprosthetic fluid and rarely infiltrating the breast parenchyma.<a class="elsevierStyleCrossRefs" href="#bib0465"><span class="elsevierStyleSup">41,42</span></a> This is a CD30+, ALK-negative tumour with a better prognosis than systemic forms of anaplastic large cell lymphoma.<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">19,40–45</span></a></p><p id="par0305" class="elsevierStylePara elsevierViewall">The first case of BIA-ALCL was reported in 1997, and since then the number of cases has gradually increased, probably due to growing numbers of breast implants and greater knowledge of the disease.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,40,43</span></a> However, the true relative and absolute risk of lymphoma in women with implants is unknown.<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">46</span></a></p><p id="par0310" class="elsevierStylePara elsevierViewall">It is usually diagnosed three to seven years following surgery, with a mean of five years following mammoplasty.<a class="elsevierStyleCrossRef" href="#bib0355"><span class="elsevierStyleSup">19</span></a> Cases have been reported in both mammoplasty due to aesthetic reasons, such as breast reconstruction, and in transgender patients. Most cases have been reported in textured implants.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,40,41,44,45</span></a></p><p id="par0315" class="elsevierStylePara elsevierViewall">At present, there is insufficient evidence that different types of implant fillers (saline and silicone) are associated with greater risk.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,47</span></a> In addition, some reported cases have occurred in families with a high risk of breast cancer; therefore, there may be an increased risk in patients with a BRCA mutation.<a class="elsevierStyleCrossRef" href="#bib0490"><span class="elsevierStyleSup">46</span></a></p><p id="par0320" class="elsevierStylePara elsevierViewall">Their pathogenesis is unknown. The following have been reported as potential risk factors: capsular contracture, subclinical infection on the surface of the implant (biofilm), repeated capsular trauma, an immune response to silicone components, a genetic predisposition and an autoimmune mechanism.<a class="elsevierStyleCrossRefs" href="#bib0265"><span class="elsevierStyleSup">1,40,43,44</span></a></p><p id="par0325" class="elsevierStylePara elsevierViewall">Notable among the main theories of the aetiopathogenesis of this activated T cell monoclonal neoplasm is the theory that it is due to chronic lymphocyte stimulation in predisposed individuals, secondary to bacterial contamination on the surface of the implant, or due to chronic inflammation caused by the silicone or polyurethane from which the implant is made.<a class="elsevierStyleCrossRefs" href="#bib0355"><span class="elsevierStyleSup">19,42,43,45,47</span></a> In addition, textured implants seem to cause a more marked local T cell-mediated response than implants with a smooth surface; hence, they may carry a greater risk of lymphoma.<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">45</span></a></p><p id="par0330" class="elsevierStylePara elsevierViewall">There are two main forms of presentation. The more common is as late-onset periprosthetic seroma, which usually corresponds to localised disease. The other is a mass in which the tumour grows on or through the capsule, with or without an associated seroma.<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">40,43,45</span></a></p><p id="par0335" class="elsevierStylePara elsevierViewall">Cases with lymphatic involvement with no breast mass, as well as cases in the non-explanted residual fibrous capsule near the prosthesis, have been reported.<a class="elsevierStyleCrossRef" href="#bib0500"><span class="elsevierStyleSup">48</span></a> Other, less common presentations are pain, erythema, skin lesions, fever and systemic signs.<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">40,42,43</span></a></p><p id="par0340" class="elsevierStylePara elsevierViewall">Therefore, the development of a periprosthetic seroma of late onset is a suspicious sign that should be evaluated by ultrasound with fine needle aspiration biopsy (FNAB) of the fluid for microbiology, cytology and flow cytometry testing (including CD30 markers). When it presents as a mass or axillary lymphadenopathy, that mass or lymphadenopathy must be biopsied and the presence of CD30 markers must be assessed.<a class="elsevierStyleCrossRef" href="#bib0485"><span class="elsevierStyleSup">45</span></a></p><p id="par0345" class="elsevierStylePara elsevierViewall">Histological diagnosis consists of demonstration of T lymphocytes of atypical morphology (very large, aberrant cells) with strong CD30 expression and negativity for ALK.</p><p id="par0350" class="elsevierStylePara elsevierViewall">Lymphomas presenting in an initial stage usually have an excellent prognosis only with explantation of the prostheses and the fibrous capsule.</p><p id="par0355" class="elsevierStylePara elsevierViewall">When there is infiltration, management must be more aggressive, with removal of the mass with negative margins and of the lymphadenopathy. Adjuvant treatment should be considered, as higher relapse rates and mortality rates of approximately 40% in two years have been reported.<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">40</span></a></p><p id="par0360" class="elsevierStylePara elsevierViewall">Neither sentinel lymph node biopsy nor lymphadenectomy is indicated as neither has been shown to decrease recurrence rates<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">40,43,45</span></a>.</p><p id="par0365" class="elsevierStylePara elsevierViewall">Involvement of the contralateral capsule has been shown in 4.6% of cases; therefore, bilateral explantation is recommended.<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">40,45</span></a></p><p id="par0370" class="elsevierStylePara elsevierViewall">Whenever BIA-ALCL is diagnosed, a suitable extension study must be conducted by PET/CT and bone marrow biopsy to rule out systemic forms of anaplastic large cell lymphoma.</p><p id="par0375" class="elsevierStylePara elsevierViewall">A specific TNM classification was recently proposed (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>).<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">40,45,49</span></a></p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Radiological diagnosis of BIA-ALCL</span><p id="par0380" class="elsevierStylePara elsevierViewall">There are no specific radiological findings.</p><p id="par0385" class="elsevierStylePara elsevierViewall">Mammography exhibits a sensitivity of 73% and a specificity of 50% for detecting abnormalities, some subtle such as capsule contour thickening or irregularity, but it does not distinguish between masses and seromas.<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">40,50</span></a></p><p id="par0390" class="elsevierStylePara elsevierViewall">Ultrasound and MRI are the best imaging techniques for their diagnosis, since they are the most sensitive techniques for detecting periprosthetic fluid. The most sensitive technique in mass detection is PET/CT (<a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>).<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">50</span></a></p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0395" class="elsevierStylePara elsevierViewall">Ultrasound is the first imaging test that must be performed in cases of clinical suspicion, in order to assess the presence of a seroma, a mass or lymphadenopathy.<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">49</span></a> It is the most cost-effective technique, and furthermore serves as a guide for seroma drainage<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">40,50,51</span></a> (<a class="elsevierStyleCrossRef" href="#fig0045">Fig. 9</a>).</p><elsevierMultimedia ident="fig0045"></elsevierMultimedia><p id="par0400" class="elsevierStylePara elsevierViewall">Breast MRI is recommended when ultrasound findings are inconclusive.<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">49</span></a> MRI assesses the presence of a seroma, a mass or lymphadenopathy. It also assesses implant integrity and associated findings such as capsule thickening and enhancement<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">50</span></a> (<a class="elsevierStyleCrossRefs" href="#fig0045">Figs. 9 and 10</a>).</p><elsevierMultimedia ident="fig0050"></elsevierMultimedia><p id="par0405" class="elsevierStylePara elsevierViewall">Confirmed cases of BIA-ALCL are staged with PET/CT.<a class="elsevierStyleCrossRef" href="#bib0505"><span class="elsevierStyleSup">49</span></a> PET/CT may identify diffuse or focal periprosthetic uptake, hypermetabolic masses and lymphadenopathy. However, no standardised uptake values (SUVs) have been established for the diagnosis of a seroma or a mass in BIA-ALCL<a class="elsevierStyleCrossRefs" href="#bib0460"><span class="elsevierStyleSup">40,43,50,52</span></a> (<a class="elsevierStyleCrossRef" href="#fig0050">Fig. 10</a>).</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Prognosis and follow-up</span><p id="par0410" class="elsevierStylePara elsevierViewall">Relapse rates following complete surgery are approximately 6%–11% in the first year. Some series have reported local recurrence rates of approximately 36% and distant recurrence rates of 64%.<a class="elsevierStyleCrossRef" href="#bib0460"><span class="elsevierStyleSup">40</span></a></p><p id="par0415" class="elsevierStylePara elsevierViewall">If excision was complete with no residual disease, follow-up every three to six months for two years with subsequent follow-up depending on clinical findings is recommended. It is recommended that a CT or a PET/CT scan be done every six months for two years with subsequent follow-up depending on the patient's clinical picture.<a class="elsevierStyleCrossRefs" href="#bib0480"><span class="elsevierStyleSup">44,45,49</span></a></p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Conclusion</span><p id="par0420" class="elsevierStylePara elsevierViewall">Breast implants can be associated with a number of complications, some of which, such as rupture, are widely known to radiologists. However, recently, more uncommon complications have been reported, and some of them, such as BIA-ALCL, are more significant.</p><p id="par0425" class="elsevierStylePara elsevierViewall">An increase in the prevalence of these more uncommon conditions can be predicted as a result of the growing use of breast implants. The clinician must be knowledgeable about them in order to be able to suitably diagnose and treat them. Of particular importance is proper management of late-onset periprosthetic seroma, the main sign of BIA-ALCL.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Authorship</span><p id="par0430" class="elsevierStylePara elsevierViewall"><ul class="elsevierStyleList" id="lis0015"><li class="elsevierStyleListItem" id="lsti0050"><span class="elsevierStyleLabel">1.</span><p id="par0435" class="elsevierStylePara elsevierViewall">Responsible for study integrity: NSR.</p></li><li class="elsevierStyleListItem" id="lsti0055"><span class="elsevierStyleLabel">2.</span><p id="par0440" class="elsevierStylePara elsevierViewall">Study conception: NSR and MJCF.</p></li><li class="elsevierStyleListItem" id="lsti0060"><span class="elsevierStyleLabel">3.</span><p id="par0445" class="elsevierStylePara elsevierViewall">Study design: NSR, MJCF, MMF, BLM and MDM.</p></li><li class="elsevierStyleListItem" id="lsti0065"><span class="elsevierStyleLabel">4.</span><p id="par0450" class="elsevierStylePara elsevierViewall">Data acquisition: NSR, MMF, MJCF, MDM and BLM.</p></li><li class="elsevierStyleListItem" id="lsti0070"><span class="elsevierStyleLabel">5.</span><p id="par0455" class="elsevierStylePara elsevierViewall">Data analysis and interpretation: NSR, MJCF, MMF, BLM and MDM.</p></li><li class="elsevierStyleListItem" id="lsti0075"><span class="elsevierStyleLabel">6.</span><p id="par0460" class="elsevierStylePara elsevierViewall">Statistical processing: N/A.</p></li><li class="elsevierStyleListItem" id="lsti0080"><span class="elsevierStyleLabel">7.</span><p id="par0465" class="elsevierStylePara elsevierViewall">Literature search: NSR, MDM and BLM.</p></li><li class="elsevierStyleListItem" id="lsti0085"><span class="elsevierStyleLabel">8.</span><p id="par0470" class="elsevierStylePara elsevierViewall">Drafting of the article: NSR.</p></li><li class="elsevierStyleListItem" id="lsti0090"><span class="elsevierStyleLabel">9.</span><p id="par0475" class="elsevierStylePara elsevierViewall">Critical review of the manuscript with intellectually significant contributions: NSR, MJCF, MMF, BLM and MDM.</p></li><li class="elsevierStyleListItem" id="lsti0095"><span class="elsevierStyleLabel">10.</span><p id="par0480" class="elsevierStylePara elsevierViewall">Approval of the final version: NSR, MMF, MJCF, BLM and MDM.</p></li></ul></p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:16 [ 0 => array:3 [ "identificador" => "xres1380149" "titulo" => "Abstract" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0005" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1267492" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1380148" "titulo" => "Resumen" "secciones" => array:1 [ 0 => array:1 [ "identificador" => "abst0010" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1267493" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Late infection" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Lymphadenopathy" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Late seroma" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Silicone-induced granulomas" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Breast fibromatosis" ] 10 => array:2 [ "identificador" => "sec0035" "titulo" => "Anaplastic large cell lymphoma" ] 11 => array:2 [ "identificador" => "sec0040" "titulo" => "Radiological diagnosis of BIA-ALCL" ] 12 => array:2 [ "identificador" => "sec0045" "titulo" => "Prognosis and follow-up" ] 13 => array:2 [ "identificador" => "sec0050" "titulo" => "Conclusion" ] 14 => array:2 [ "identificador" => "sec0055" "titulo" => "Authorship" ] 15 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-09-25" "fechaAceptado" => "2020-01-31" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1267492" "palabras" => array:10 [ 0 => "Breast implants" 1 => "Breast cancer" 2 => "Breast surgery" 3 => "Late seroma" 4 => "Late infection" 5 => "Fibrous capsule granuloma" 6 => "Breast fibromatosis" 7 => "Internal mammary chain adenopathies" 8 => "Large cell anaplastic lymphoma" 9 => "Magnetic resonance imaging" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1267493" "palabras" => array:10 [ 0 => "Implantes mamarios" 1 => "Cáncer de mama" 2 => "Cirugía de mama" 3 => "Seroma tardío" 4 => "Infección tardía" 5 => "Granulomas de la cápsula fibrosa" 6 => "Fibromatosis mamaria" 7 => "Adenopatías de la cadena mamaria interna" 8 => "Linfoma anaplásico de células grandes" 9 => "Resonancia magnética de mama" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Breast implants are associated with well-known common complications that have been widely studied, such as rupture and capsular contraction. However, the increasingly growing number of patients with breast implants has led to the increased likelihood of coming across less common complications; these include seromas or late infection; adenopathies in the internal mammary chain; granulomas in the capsule of the implant, which in some cases can extend beyond the fibrous capsule; desmoid tumours associated with the implants; and breast implant-associated large cell anaplastic lymphoma.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">This article aims to review the main uncommon complications associated with breast implants and to describe and illustrate their findings in different imaging techniques. Proper management of these complications is important; this is especially true of late seroma and the diagnosis of breast implant-associated large cell anaplastic lymphoma for their repercussions.</p></span>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span id="abst0010" class="elsevierStyleSection elsevierViewall"><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Los implantes mamarios se asocian a complicaciones frecuentes ampliamente conocidas y estudiadas como la rotura y la contractura capsular. Sin embargo, debido al número cada vez mayor de pacientes portadoras de implantes mamarios, podemos encontrarnos con patología más infrecuente como la presencia de seroma o infección tardía, adenopatías en la cadena mamaria interna, granulomas en la cápsula del implante –que en algunos casos pueden extenderse más allá de la cápsula fibrosa–, tumores desmoides asociados a los implantes y el linfoma anaplásico de células grandes asociado a implantes mamarios. El objetivo de este artículo es revisar las principales complicaciones infrecuentes asociadas a los implantes mamarios y sus hallazgos radiológicos en las diferentes técnicas. Es importante un correcto manejo de esta patología, principalmente del seroma tardío, para diagnosticar precozmente el linfoma anaplásico de células grandes por su mayor transcendencia.</p></span>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Sánchez Rubio N, Lannegrand Menéndez B, Duque Muñoz M, Montes Fernández M, Ciudad Fernández MJ. Complicaciones infrecuentes de las prótesis de mama. Radiología. 2020. <span class="elsevierStyleInterRef" id="intr0005" href="https://doi.org/10.1016/j.rx.2020.01.008">https://doi.org/10.1016/j.rx.2020.01.008</span></p>" ] ] "multimedia" => array:13 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1239 "Ancho" => 2508 "Tamanyo" => 401617 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Late infection. (A) A heterogeneous periprosthetic collection (*) with the presence of septa (arrow) was identified on ultrasound. (B) Axial STIR. (C) Diffusion. (D) Sagittal T2. (E) Axial T1 following administration of intravenous contrast. Moderate periprosthetic seroma (*) with intact implant. It presented restricted diffusion and diffuse enhancement of the fibrous capsule (arrow). (F) Cell block (200× H&E staining) consisting of polymorphonuclear leukocytes in a proteinaceous fluid.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 815 "Ancho" => 2508 "Tamanyo" => 164793 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Lymphadenopathy in the internal mammary lymph node chain. A patient with a history of left mastectomy due to breast cancer and right prophylactic mastectomy with reconstruction with bilateral prostheses. The follow-up PET/CT scan identified the appearance of lymphadenopathy in the left internal mammary lymph node chain with uptake arousing suspicion of relapse (arrow). Fine needle aspiration biopsy was performed but did not identify any signs of relapse.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 2647 "Ancho" => 2508 "Tamanyo" => 440726 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Late seroma. (A) Craniocaudal mammography of the right breast showing a modest increase in density adjacent to the inner aspect of the prosthesis, with no abnormality on its contour (arrow). (B) On ultrasound it corresponded to a small amount of anechogenic fluid (*). (C) STIR axial MRI. (D) Sagittal T1 following administration of intravenous contrast. Small periprosthetic seroma (*) with implant integrity. It was associated with diffuse modest enhancement of the fibrous capsule (arrow). Evacuating fine needle aspiration biopsy of the periprosthetic fluid was performed and no cause could be identified (idiopathic seroma).</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1801 "Ancho" => 2508 "Tamanyo" => 413381 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Intracapsular granuloma. (A) Axial T2 MRI. (B) Axial T1 following administration of intravenous contrast. Hyperintense mass in T2-enhanced sequences (arrow) of intracapsular location posterior to the prosthesis in the left breast. Intact fibrous capsule. Following administration of intravenous contrast, thickening and enhancement of the posterior aspect of the fibrous capsule (dashed arrow) adjacent to the mass without clear enhancement of the mass was identified. (C) Diffuse modest uptake by the posterior aspect of the fibrous capsule (dashed arrow) with no uptake by the mass was identified on PET/CT. (D) 200× H&E staining of the fibrous capsule showing cystic spaces containing pale extracellular material consistent with silicone, surrounded by vacuolated histiocytes, lymphocytes and multi-nucleated giant cells.</p>" ] ] 4 => array:7 [ "identificador" => "fig0025" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1602 "Ancho" => 2500 "Tamanyo" => 390766 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Extracapsular granuloma. (A) Ultrasound showing a large heterogeneous mass in contact with the breast implant which was found to be displaced (*). (B–D) Axial and sagittal T2. Heterogeneous intracapsular mass leading to a mass effect on the retroglandular implant (*). Loss of the integrity of the fibrous capsule with incipient spread towards the adjacent parenchyma was identified (solid arrow). The normal capsule was visualised as a hypointense line surrounding the mass (dashed arrow). There was lymphadenopathy with signs of silicone infiltration (arrow in D). (E and F) Perfusion map and kinetic curve showing the mass with areas of high perfusion and kinetic curves with rapid initial uptake and late-phase washout (type 3).</p>" ] ] 5 => array:7 [ "identificador" => "fig0030" "etiqueta" => "Figure 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 791 "Ancho" => 2508 "Tamanyo" => 169191 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Breast fibromatosis. (A and B) Craniocaudal and mediolateral oblique mammography of the right breast. Mass with well-defined borders in the outer quadrants of the breast (arrow). The mass was found to be in close contact with the outer and posterior aspect of the prosthesis with effacement of the contour of the prosthesis and anterior displacement thereof. (C and D) On ultrasound it corresponded to a large heterogeneous mass with relatively well-defined borders in close contact with the prosthesis.</p>" ] ] 6 => array:7 [ "identificador" => "fig0035" "etiqueta" => "Figure 7" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr7.jpeg" "Alto" => 1660 "Ancho" => 2508 "Tamanyo" => 418789 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Breast fibromatosis (same case as in <a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>). (A) Axial T1. A large isointense mass, located in close contact with and posterior to the right implant with anterior displacement of the prosthesis and a significant increase in breast volume. The split fat sign, consisting of a fine halo of fat surrounding the lesion, was identified (white arrow). (B) Sagittal T2 showing the hyperintense mass with small hypointense areas inside the lesion (orange arrow). (C and D) MRI following administration of intravenous contrast. The mass presented significant contrast uptake with the presence of small hypointense areas (orange arrow) corresponding to the presence of collagen fibres with limited cellularity. It presented local infiltration with spread through the intercostal space towards the thorax (white arrow). (E and F) Perfusion map and kinetic curve showing increased perfusion with a plateau (type 2) kinetic curve.</p>" ] ] 7 => array:7 [ "identificador" => "fig0040" "etiqueta" => "Figure 8" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr8.jpeg" "Alto" => 1860 "Ancho" => 2508 "Tamanyo" => 431374 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Breast fibromatosis. (A and B) Ultrasound: well-defined hypoechogenic retropectoral mass in contact with the prosthesis extending through the intercostal space (dashed arrow). Fascial tail sign (solid arrow in (A)) consisting of linear extensions towards the lateral margins. (C) PET/CT: the mass was slightly hypermetabolic (solid arrow). (D) Pathology (200× H&E staining): fusiform cell bundles in a collagen-rich stroma with scattered lymphocytes and extravasated red blood cells.</p>" ] ] 8 => array:7 [ "identificador" => "fig0045" "etiqueta" => "Figure 9" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr9.jpeg" "Alto" => 1786 "Ancho" => 2508 "Tamanyo" => 359658 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">BIA-ALCL. (A) Ultrasound showing modest periprosthetic seroma in the left breast (*). (B) Axial T2 MRI. (C) Diffusion. (D) Axial T1 following administration of contrast. Modest periprosthetic seroma (*) with implant integrity. The seroma presented restricted diffusion (red arrow) and mild diffuse enhancement of the fibrous capsule (white arrow). Fine needle aspiration biopsy of the periprosthetic fluid was performed and confirmed the diagnosis.</p>" ] ] 9 => array:7 [ "identificador" => "fig0050" "etiqueta" => "Figure 10" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr10.jpeg" "Alto" => 910 "Ancho" => 2508 "Tamanyo" => 144820 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">BIA-ALCL. (A) Axial T2 MRI identifying a periprosthetic seroma with implant integrity. Evacuating fine needle aspiration biopsy was performed and confirmed BIA-ALCL. On PET/CT following seroma evacuation modest hyperuptake of the anterior aspect of the periprosthetic capsule (arrow) was identified.</p>" ] ] 10 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">CNB: core needle biopsy; FNAB: fine needle aspiration biopsy; MRI: magnetic resonance imaging; PET/CT: positron emission tomography/computed tomography; US: ultrasound.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Complications \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Time period following surgery \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Clinical signs \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Radiological findings \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Treatment \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Common \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Perioperative period \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Infection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Perioperative period \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fever, pain and inflammation \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Periprosthetic collection with or without content \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antibiotics \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Periprosthetic collections (haematoma, seroma) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Pain and increased breast volume \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Haematoma: heterogeneous collection. Seroma: anechogenic collection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Percutaneous drainage depending on signs and symptoms \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Late \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Capsular contracture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">After 3 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Inflamed, deformed and painful breast \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">The diagnosis is clinical. Increase in the anterior–posterior diameter of the implant, thickening and calcifications of the capsule \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prosthesis explantation and capsulectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Prosthetic rupture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Greater probability after 10 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">No symptoms, or deformity, pain and oedema \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Intracapsular</span>: US: stepladder sign. MRI: teardrop or keyhole sign, subcapsular line sign or linguine sign<span class="elsevierStyleItalic">Extracapsular</span>: spread of silicone through the capsule. US: “snowstorm” sign \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prosthesis explantation \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Uncommon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Late \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Infection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Months or years following surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Fever, pain, erythema and inflammation. Secondary to systemic infection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Periprosthetic collection with or without content<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>oedema and skin thickening \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Antibiotics \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Late seroma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">After one year \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Increased breast volume and pain \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Periprosthetic collection<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>capsule thickening \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Conservative \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Granuloma \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">After 2 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Signs of capsular contracture \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">Intracapsular</span>: heterogeneous mass with high signal in T2 sequences. Gradual late (>4<span class="elsevierStyleHsp" style=""></span>min) enhancement. Negative PET/CT<span class="elsevierStyleItalic">Extracapsular</span>: capsule-infiltrating mass. Early enhancement. Axillary lymphadenopathy<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>positive PET/CT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Prosthesis explantation and capsulectomy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Breast fibromatosis associated with implants \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">After 2 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Firm, painless mass \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Infiltrating mass with relatively well-defined marginsMRI: signal in T2 and variable enhancement kinetics depending on stage. Hypointense areas in all sequencesPET/CT: slight uptake \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Wide local excision with negative margins \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• BIA-ALCL \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">After 3 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sudden increase in breast volume+ freq. of textured implants \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2/3 periprosthetic seroma1/3 capsule-affecting mass<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>lymphadenopathy. PET/CT: periprosthetic uptake or hypermetabolic mass \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Capsulectomy and prosthesis explantation. Adjuvant treatment if advanced disease \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">• Lymphadenopathy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">After 6 years \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Depending on size and location \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Larger lymphadenopathy with or without uptake on PET/CT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Conservative CNB/FNAB if relapse is suspected \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2369720.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Summary of complications associated with breast implants.</p>" ] ] 11 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">BIA-ALCL: breast implant-associated anaplastic large cell lymphoma.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">TNM Description</span> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">T: Tumour extentT1: Confined to seromaT2: Early capsule infiltrationT3: Cell aggregates infiltrating the capsuleT4: Infiltrates beyond the capsule \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">N: Lymph nodes</span>N0: No lymph node involvementN1: One regional lymph node (+)N2: Multiple regional lymph nodes (+) \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">M: Metastasis</span>M0: No distant spreadM1: Spread to other organs/distant sites \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t"><span class="elsevierStyleItalic">TNM STAGING</span>IA: T1 N0 M0IB: T2 N0 M0IC: T3 N0 M0IIA: T4 N0 M0IIB: T1–3 N1 M0III: T4 N1–2 M0IV: Any T Any N M1 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2369721.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">National Comprehensive Cancer Network BIA-ALCL TNM classification (2019).</p>" ] ] 12 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">CT: computed tomography; MRI: magnetic resonance imaging; PET/CT: positron emission tomography/computed tomography.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Seroma</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " colspan="2" align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Mass</th></tr><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sensitivity(%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Specificity(%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Sensitivity(%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Specificity(%) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Ultrasound \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">84 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">46 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MRI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">82 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">93 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">55 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">50 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">100 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">PET/CT \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">83 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">64 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="char" valign="\n \t\t\t\t\ttop\n \t\t\t\t">88 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2369719.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Sensitivity and specificity for each imaging modality in detecting a seroma or a mass in patients with BIA-ALCL.<a class="elsevierStyleCrossRef" href="#bib0510"><span class="elsevierStyleSup">50</span></a></p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:52 [ 0 => array:3 [ "identificador" => "bib0265" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adverse effects and imaging appearances of breast implants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K. Faguy" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Radiol Technol" "fecha" => "2018" "volumen" => "89" "paginaInicial" => "467" "paginaFinal" => "482" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29793907" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0270" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Multimodality imaging-based evaluation of single-lumen silicone breast implants for rupture" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S.J. Seiler" 1 => "P.B. Sharma" 2 => "J.C. Hayes" 3 => "R. Ganti" 4 => "A.R. Mootz" 5 => "E.D. Eads" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/rg.2017160086" "Revista" => array:6 [ "tituloSerie" => "Radiographics" "fecha" => "2017" "volumen" => "37" "paginaInicial" => "366" "paginaFinal" => "382" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28186859" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0275" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The diagnosis of breast implant rupture: MRI findings compared with findings at explantation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.R. Hölmich" 1 => "I. Vejborg" 2 => "C. Conrad" 3 => "S. Sletting" 4 => "J.K. McLaughlin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejrad.2004.03.012" "Revista" => array:6 [ "tituloSerie" => "Eur J Radiol" "fecha" => "2005" "volumen" => "53" "paginaInicial" => "213" "paginaFinal" => "225" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/15664285" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0280" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Review of breast augmentation and reconstruction for the radiologist with emphasis on MRI" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L.A. Green" 1 => "J.A. Karow" 2 => "J.E. Toman" 3 => "A. Lostumbo" 4 => "K. Xie" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.clinimag.2017.08.007" "Revista" => array:6 [ "tituloSerie" => "Clin Imaging" "fecha" => "2018" "volumen" => "47" "paginaInicial" => "101" "paginaFinal" => "117" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28918365" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0285" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Infections in breast implants: a review with a focus on developing countries" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "C. Rubino" 1 => "S. Brongo" 2 => "D. Pagliara" 3 => "R. Cuomo" 4 => "G. Abbinante" 5 => "N. Campitiello" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.3855/jidc.3898" "Revista" => array:6 [ "tituloSerie" => "J Infect Dev Ctries" "fecha" => "2014" "volumen" => "8" "paginaInicial" => "1089" "paginaFinal" => "1095" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25212072" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0290" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Late hematogenous bacterial infections of breast implants: two case reports of unique bacterial infections" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J. Chang" 1 => "G.W. Lee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/SAP.0b013e3181f3e387" "Revista" => array:6 [ "tituloSerie" => "Ann Plast Surg" "fecha" => "2011" "volumen" => "67" "paginaInicial" => "14" "paginaFinal" => "16" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21508821" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0295" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging of breast implants and their associated complications" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "R. Roller" 1 => "A. Chetlen" 2 => "C. Kasales" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Am Osteopath Coll Radiol" "fecha" => "2014" "volumen" => "3" "paginaInicial" => "2" "paginaFinal" => "9" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25328855" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0300" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Salvage of infected breast implants" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J.H. Song" 1 => "Y.S. Kim" 2 => "B.K. Jung" 3 => "D.W. Lee" 4 => "S.Y. Song" 5 => "T.S. Roh" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Plastic Surg" "fecha" => "2017" "volumen" => "44" "paginaInicial" => "516" "paginaFinal" => "522" ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0305" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Imaging of common breast implants and implant-related complications: a pictorial essay" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.T. Shah" 1 => "B.B. Jankharia" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0971-3026.184409" "Revista" => array:6 [ "tituloSerie" => "Indian J Radiol Imaging" "fecha" => "2016" "volumen" => "26" "paginaInicial" => "216" "paginaFinal" => "225" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27413269" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0310" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Incidence of internal mammary lymph nodes with silicone breast implants at MR imaging after oncoplastic surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E.J. Sutton" 1 => "E.J. Watson" 2 => "G. Gibbons" 3 => "D.A. Goldman" 4 => "C.S. Moskowitz" 5 => "M.S. Jochelson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1148/radiol.2015142717" "Revista" => array:6 [ "tituloSerie" => "Radiology" "fecha" => "2015" "volumen" => "277" "paginaInicial" => "381" "paginaFinal" => "387" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26098457" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0315" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silicone lymphadenopathy after breast augmentation: case reports, review of the literature, and current thoughts" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G.J. Zambacos" 1 => "C. Molnar" 2 => "A.D. Mandrekas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00266-012-0025-9" "Revista" => array:6 [ "tituloSerie" => "Aesthetic Plast Surg" "fecha" => "2013" "volumen" => "37" "paginaInicial" => "278" "paginaFinal" => "289" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/23354761" "web" => "Medline" ] ] ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0320" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Management of late seroma in patients with breast implants: the role of the radiologists" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Graña López" 1 => "M. Vázquez Caruncho" 2 => "Á. Villares Armas" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/tbj.12665" "Revista" => array:6 [ "tituloSerie" => "Breast J" "fecha" => "2016" "volumen" => "22" "paginaInicial" => "705" "paginaFinal" => "707" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27508944" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0325" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A clinical study of late seroma in breast implantation surgery" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M. Mazzocchi" 1 => "L.A. Dessy" 2 => "F. Corrias" 3 => "N. Scuderi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00266-011-9755-3" "Revista" => array:6 [ "tituloSerie" => "Aesthetic Plast Surg" "fecha" => "2012" "volumen" => "36" "paginaInicial" => "97" "paginaFinal" => "104" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21638164" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0330" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Understanding rare adverse sequelae of breast implants: anaplastic large-cell lymphoma, late seromas, and double capsules" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.W. Clemens" 1 => "M.B. Nava" 2 => "N. Rocco" 3 => "R.N. Miranda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.21037/gs.2016.11.03" "Revista" => array:6 [ "tituloSerie" => "Gland Surg" "fecha" => "2017" "volumen" => "6" "paginaInicial" => "169" "paginaFinal" => "184" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28497021" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0335" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Late seromas after breast implants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.L. Spear" 1 => "S.J. Rottman" 2 => "C. Glicksman" 3 => "M. Brown" 4 => "A. Al-Attar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PRS.0b013e3182589ea9" "Revista" => array:6 [ "tituloSerie" => "Plast Reconstr Surg" "fecha" => "2012" "volumen" => "130" "paginaInicial" => "423" "paginaFinal" => "435" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22495216" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0340" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Managing late periprosthetic fluid collections (seroma) in patients with breast implants: a consensus panel recommendation and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B. Bengtson" 1 => "G.S. Brody" 2 => "M.H. Brown" 3 => "C. Glicksman" 4 => "D. Hammond" 5 => "H. Kaplan" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/PRS.0b013e318217fdb0" "Revista" => array:6 [ "tituloSerie" => "Plast Reconstr Surg" "fecha" => "2011" "volumen" => "128" "paginaInicial" => "1" "paginaFinal" => "7" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/21441845" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0345" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cytological diagnostic features of late breast implant seromas: from reactive to anaplastic large cell lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. di Napoli" 1 => "G. Pepe" 2 => "E. Giarnieri" 3 => "C. Cippitelli" 4 => "A. Bonifacino" 5 => "M. Mattei" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1371/journal.pone.0181097" "Revista" => array:5 [ "tituloSerie" => "PLOS ONE" "fecha" => "2017" "volumen" => "12" "paginaInicial" => "e0181097" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28715445" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0350" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast magnetic resonance imaging: tips for the diagnosis of silicone-induced granuloma of a breast implant capsule (SIGBIC)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. de Faria Castro Fleury" 1 => "A.C. Gianini" 2 => "V. Ayres" 3 => "L.C. Ramalho" 4 => "R.O. Seleti" 5 => "D. Roveda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s13244-017-0564-3" "Revista" => array:6 [ "tituloSerie" => "Insights Imaging" "fecha" => "2017" "volumen" => "8" "paginaInicial" => "439" "paginaFinal" => "446" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28710678" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0355" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silicone-induced granuloma of breast implant capsule (SIGBIC): similarities and differences with anaplastic large cell lymphoma (ALCL) and their differential diagnosis" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "E. de Faria Castro Fleury" 1 => "M.M. Rêgo" 2 => "L.C. Ramalho" 3 => "V.J. Ayres" 4 => "R.O. Seleti" 5 => "C.A. Pecci Ferreira" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Breast Cancer (Dove Med Press)" "fecha" => "2017" "volumen" => "9" "paginaInicial" => "133" "paginaFinal" => "140" ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0360" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silicone-induced granuloma of breast implant capsule (SIGBIC): histopathology and radiological correlation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "E. de Faria Castro Fleury" 1 => "G.S. D’Alessandro" 2 => "S.C.L. Wludarski" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Immunol Res" "fecha" => "2018" "volumen" => "2018" "paginaInicial" => "1" "paginaFinal" => "9" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0365" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Long-term inflammatory conditions following silicone exposure: the expanding spectrum of the autoimmune/inflammatory syndrome induced by adjuvants (ASIA)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Soriano" 1 => "D. Butnaru" 2 => "Y. Shoenfeld" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Clin Exp Rheumatol" "fecha" => "2014" "volumen" => "32" "paginaInicial" => "151" "paginaFinal" => "154" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24739519" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0370" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Two hundreds cases of ASIA syndrome following silicone implants: a comparative study of 30 years and a review of current literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.J.L. Colaris" 1 => "M. de Boer" 2 => "R.R. van der Hulst" 3 => "J.W. Cohen Tervaert" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s12026-016-8821-y" "Revista" => array:6 [ "tituloSerie" => "Immunol Res" "fecha" => "2017" "volumen" => "65" "paginaInicial" => "120" "paginaFinal" => "128" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/27406737" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0375" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Application of breast ultrasound elastography to differentiate intracapsular collection from silicone-induced granuloma of breast implant capsule complementarily to contrast-enhanced breast magnetic resonance imaging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. de Faria Castro Fleury" 1 => "A.C. Gianini" 2 => "V. Ayres" 3 => "L.C. Ramalho" 4 => "D. Roveda" 5 => "V.M. de Oliveira" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1177/1178223417737994" "Revista" => array:3 [ "tituloSerie" => "Breast Cancer (Auckl)" "fecha" => "2017" "volumen" => "11" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0380" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "MRI diagnosis and follow-up of chest wall and breast desmoid tumours in patients with a history of oncologic breast surgery and silicone implants: a pictorial report" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Grubstein" 1 => "Y. Rapson" 2 => "A. Zer" 3 => "I. Gadiel" 4 => "E. Atar" 5 => "S. Morgenstern" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/1754-9485.12829" "Revista" => array:6 [ "tituloSerie" => "J Med Imaging Radiat Oncol" "fecha" => "2019" "volumen" => "63" "paginaInicial" => "47" "paginaFinal" => "53" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30443994" "web" => "Medline" ] ] ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0385" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A desmoid tumour associated with a breast prosthesis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F. Gergelé" 1 => "F. Guy" 2 => "F. Collin" 3 => "D. Krausé" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Diagn Interv Imaging" "fecha" => "2012" "volumen" => "93" "paginaInicial" => "200" "paginaFinal" => "203" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0390" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desmoid tumour of the breast" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Chummun" 1 => "N.R. McLean" 2 => "S. Abraham" 3 => "M. Youseff" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.bjps.2008.09.024" "Revista" => array:6 [ "tituloSerie" => "J Plast Reconstr Aesthet Surg" "fecha" => "2010" "volumen" => "63" "paginaInicial" => "339" "paginaFinal" => "345" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19059821" "web" => "Medline" ] ] ] ] ] ] ] ] 26 => array:3 [ "identificador" => "bib0395" "etiqueta" => "27" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast fibromatosis associated with breast implants" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "Y.N. Seo" 1 => "Y.M. Park" 2 => "H.K. Yoon" 3 => "S.J. Lee" 4 => "H.J. Choo" 5 => "J.H. Ryu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s11604-015-0461-y" "Revista" => array:6 [ "tituloSerie" => "Jpn J Radiol" "fecha" => "2015" "volumen" => "33" "paginaInicial" => "591" "paginaFinal" => "597" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26213262" "web" => "Medline" ] ] ] ] ] ] ] ] 27 => array:3 [ "identificador" => "bib0400" "etiqueta" => "28" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Radiologic images of an aggressive implant-associated fibromatosis of the breast and chest wall: case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "L. Alanis" 1 => "R. Roth" 2 => "N. Lerman" 3 => "J.E. Barroeta" 4 => "P. Germaine" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.radcr.2017.04.012" "Revista" => array:6 [ "tituloSerie" => "Radiol Case Rep" "fecha" => "2017" "volumen" => "12" "paginaInicial" => "431" "paginaFinal" => "438" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28828097" "web" => "Medline" ] ] ] ] ] ] ] ] 28 => array:3 [ "identificador" => "bib0405" "etiqueta" => "29" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desmoid tumor and silicone breast implant surgery: is there really a connection? A literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Tzur" 1 => "E. Silberstein" 2 => "Y. Krieger" 3 => "Y. Shoham" 4 => "Y. Rafaeli" 5 => "A. Bogdanov-Berezovsky" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00266-017-0948-2" "Revista" => array:6 [ "tituloSerie" => "Aesthetic Plast Surg" "fecha" => "2018" "volumen" => "42" "paginaInicial" => "59" "paginaFinal" => "63" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28842766" "web" => "Medline" ] ] ] ] ] ] ] ] 29 => array:3 [ "identificador" => "bib0410" "etiqueta" => "30" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast fibromatosis, an unusual breast disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "K. Abdelwahab" 1 => "O. Hamdy" 2 => "M. Zaky" 3 => "N. Megahed" 4 => "S. Elbalka" 5 => "M. Elmetwally" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jscr/rjx248" "Revista" => array:2 [ "tituloSerie" => "J Surg Case Rep" "fecha" => "2017" ] ] ] ] ] ] 30 => array:3 [ "identificador" => "bib0415" "etiqueta" => "31" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fibromatosis associated with silicone breast implant: ultrasonography and MR imaging findings" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H.S. Shim" 1 => "S.-J. Kim" 2 => "O.H. Kim" 3 => "H.K. Jung" 4 => "S.J. Kim" 5 => "W. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/tbj.12340" "Revista" => array:6 [ "tituloSerie" => "Breast J" "fecha" => "2014" "volumen" => "20" "paginaInicial" => "645" "paginaFinal" => "649" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25251931" "web" => "Medline" ] ] ] ] ] ] ] ] 31 => array:3 [ "identificador" => "bib0420" "etiqueta" => "32" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desmoid tumors (fibromatoses) of the breast: a 25-year experience" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "H.B. Neuman" 1 => "E. Brogi" 2 => "A. Ebrahim" 3 => "M.F. Brennan" 4 => "K.J. van Zee" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1245/s10434-007-9580-8" "Revista" => array:6 [ "tituloSerie" => "Ann Surg Oncol" "fecha" => "2008" "volumen" => "15" "paginaInicial" => "274" "paginaFinal" => "280" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17896146" "web" => "Medline" ] ] ] ] ] ] ] ] 32 => array:3 [ "identificador" => "bib0425" "etiqueta" => "33" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mammary fibromatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K.N. Glazebrook" 1 => "C.A. Reynolds" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.2214/AJR.08.1892" "Revista" => array:6 [ "tituloSerie" => "AJR" "fecha" => "2009" "volumen" => "193" "paginaInicial" => "856" "paginaFinal" => "860" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19696302" "web" => "Medline" ] ] ] ] ] ] ] ] 33 => array:3 [ "identificador" => "bib0430" "etiqueta" => "34" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Fibromatosis of the breast: a pictorial review of the imaging and histopathology findings" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L. Ebrahim" 1 => "J. Parry" 2 => "D.B. Taylor" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.crad.2014.05.105" "Revista" => array:6 [ "tituloSerie" => "Clin Radiol" "fecha" => "2014" "volumen" => "69" "paginaInicial" => "1077" "paginaFinal" => "1083" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24990452" "web" => "Medline" ] ] ] ] ] ] ] ] 34 => array:3 [ "identificador" => "bib0435" "etiqueta" => "35" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silicone breast implant associated fibromatosis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Hill" 1 => "A. Merrill" 2 => "S. Korourian" 3 => "G. Bryant-Smith" 4 => "R. Henry-Tillman" 5 => "D. Ochoa" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/jscr/rjy249" "Revista" => array:2 [ "tituloSerie" => "J Surg Case Rep" "fecha" => "2018" ] ] ] ] ] ] 35 => array:3 [ "identificador" => "bib0440" "etiqueta" => "36" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Desmoid-type fibromatosis of the thorax" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "H. Xu" 1 => "H.J. Koo" 2 => "S. Lim" 3 => "J.W. Lee" 4 => "H.N. Lee" 5 => "D.K. Kim" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/MD.0000000000001547" "Revista" => array:5 [ "tituloSerie" => "Medicine" "fecha" => "2015" "volumen" => "94" "paginaInicial" => "e1547" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26402812" "web" => "Medline" ] ] ] ] ] ] ] ] 36 => array:3 [ "identificador" => "bib0445" "etiqueta" => "37" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Case report. PET/CT appearance of desmoid tumour of the chest wall" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "F.F. Souza" 1 => "F.M. Fennessy" 2 => "Q. Yang" 3 => "A.D. van den Abbeele" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/bjr/18648939" "Revista" => array:6 [ "tituloSerie" => "Br J Radiol" "fecha" => "2010" "volumen" => "83" "paginaInicial" => "e39" "paginaFinal" => "e42" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20139256" "web" => "Medline" ] ] ] ] ] ] ] ] 37 => array:3 [ "identificador" => "bib0450" "etiqueta" => "38" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Uptake characteristics of fluorodeoxyglucose (FDG) in deep fibromatosis and abdominal desmoids: potential clinical role of FDG-PET in the management" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "S. Basu" 1 => "N. Nair" 2 => "S. Banavali" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/bjr/53719785" "Revista" => array:6 [ "tituloSerie" => "Br J Radiol" "fecha" => "2007" "volumen" => "80" "paginaInicial" => "750" "paginaFinal" => "756" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17709361" "web" => "Medline" ] ] ] ] ] ] ] ] 38 => array:3 [ "identificador" => "bib0455" "etiqueta" => "39" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast fibromatosis: making the case for primary vs secondary subtypes" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "S. Ghanta" 1 => "A. Allen" 2 => "A.H. Vinyard" 3 => "R. Berger" 4 => "J. Aoun" 5 => "J. Rosenkrantz Spoont" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/tbj.13506" "Revista" => array:4 [ "tituloSerie" => "Breast J" "fecha" => "2019" "paginaInicial" => "1" "paginaFinal" => "5" ] ] ] ] ] ] 39 => array:3 [ "identificador" => "bib0460" "etiqueta" => "40" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast implant-associated anaplastic large cell lymphoma – from diagnosis to treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. Kaartinen" 1 => "K. Sunela" 2 => "J. Alanko" 3 => "K. Hukkinen" 4 => "M.-L. Karjalainen-Lindsberg" 5 => "C. Svarvar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.ejso.2017.05.021" "Revista" => array:6 [ "tituloSerie" => "Eur J Surg Oncol" "fecha" => "2017" "volumen" => "43" "paginaInicial" => "1385" "paginaFinal" => "1392" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28625797" "web" => "Medline" ] ] ] ] ] ] ] ] 40 => array:3 [ "identificador" => "bib0465" "etiqueta" => "41" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast implant-associated anaplastic large cell lymphoma: case report and review of the literature" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "E. Berlin" 1 => "K. Singh" 2 => "C. Mills" 3 => "I. Shapira" 4 => "R.L. Bakst" 5 => "M. Chadha" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Case Rep Hematol" "fecha" => "2018" "volumen" => "2018" "paginaInicial" => "1" "paginaFinal" => "6" ] ] ] ] ] ] 41 => array:3 [ "identificador" => "bib0470" "etiqueta" => "42" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Silicone implants and lymphoma: the role of inflammation" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. Bizjak" 1 => "C. Selmi" 2 => "S. Praprotnik" 3 => "O. Bruck" 4 => "C. Perricone" 5 => "M. Ehrenfeld" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaut.2015.08.009" "Revista" => array:6 [ "tituloSerie" => "J Autoimmun" "fecha" => "2015" "volumen" => "65" "paginaInicial" => "64" "paginaFinal" => "73" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26330346" "web" => "Medline" ] ] ] ] ] ] ] ] 42 => array:3 [ "identificador" => "bib0475" "etiqueta" => "43" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Coming of age: breast implant-associated anaplastic large cell lymphoma after 18 years of investigation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M.W. Clemens" 1 => "R.N. Miranda" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.cps.2015.06.006" "Revista" => array:6 [ "tituloSerie" => "Clin Plast Surg" "fecha" => "2015" "volumen" => "42" "paginaInicial" => "605" "paginaFinal" => "613" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/26408447" "web" => "Medline" ] ] ] ] ] ] ] ] 43 => array:3 [ "identificador" => "bib0480" "etiqueta" => "44" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How to diagnose and treat breast implant-associated anaplastic large cell lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.W. Clemens" 1 => "G.S. Brody" 2 => "R.C. Mahabir" 3 => "R.N. Miranda" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Plast Reconstr Surg" "fecha" => "2018" "volumen" => "141" ] ] ] ] ] ] 44 => array:3 [ "identificador" => "bib0485" "etiqueta" => "45" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "How I treat breast implant-associated anaplastic large cell lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "N. Mehta-Shah" 1 => "M.W. Clemens" 2 => "S.M. Horwitz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1182/blood-2018-03-785972" "Revista" => array:6 [ "tituloSerie" => "Blood" "fecha" => "2018" "volumen" => "132" "paginaInicial" => "1889" "paginaFinal" => "1898" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30209119" "web" => "Medline" ] ] ] ] ] ] ] ] 45 => array:3 [ "identificador" => "bib0490" "etiqueta" => "46" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast implants and the risk of anaplastic large-cell lymphoma in the breast" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M. de Boer" 1 => "F.E. van Leeuwen" 2 => "M. Hauptmann" 3 => "L.I.H. Overbeek" 4 => "J.P. de Boer" 5 => "N.J. Hijmering" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/jamaoncol.2017.4510" "Revista" => array:6 [ "tituloSerie" => "JAMA Oncol" "fecha" => "2018" "volumen" => "4" "paginaInicial" => "335" "paginaFinal" => "341" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/29302687" "web" => "Medline" ] ] ] ] ] ] ] ] 46 => array:3 [ "identificador" => "bib0495" "etiqueta" => "47" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast implant-associated anaplastic large cell lymphoma (ALCL): a case report" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "S. Evren" 1 => "T. Khoury" 2 => "V. Neppalli" 3 => "H. Cappuccino" 4 => "F.J. Hernandez-Ilizaliturri" 5 => "P. Kumar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.12659/ajcr.903161" "Revista" => array:6 [ "tituloSerie" => "Am J Case Rep" "fecha" => "2017" "volumen" => "18" "paginaInicial" => "605" "paginaFinal" => "610" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/28559535" "web" => "Medline" ] ] ] ] ] ] ] ] 47 => array:3 [ "identificador" => "bib0500" "etiqueta" => "48" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast implant-associated anaplastic large cell lymphoma: a pictorial review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A. Chacko" 1 => "T. Lloyd" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s13244-018-0652-z" "Revista" => array:6 [ "tituloSerie" => "Insights imaging" "fecha" => "2018" "volumen" => "9" "paginaInicial" => "683" "paginaFinal" => "686" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30187266" "web" => "Medline" ] ] ] ] ] ] ] ] 48 => array:3 [ "identificador" => "bib0505" "etiqueta" => "49" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "2019 NCCN Consensus Guidelines on the Diagnosis and Treatment of Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "M.W. Clemens" 1 => "E.D. Jacobsen" 2 => "S.M. Horwitz" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1093/asj/sjy331" "Revista" => array:6 [ "tituloSerie" => "Aesthet Surg J" "fecha" => "2019" "volumen" => "39" "paginaInicial" => "S3" "paginaFinal" => "S13" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30715173" "web" => "Medline" ] ] ] ] ] ] ] ] 49 => array:3 [ "identificador" => "bib0510" "etiqueta" => "50" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast implant-associated anaplastic large cell lymphoma: sensitivity, specificity, and findings of imaging studies in 44 patients" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.E. Adrada" 1 => "R.N. Miranda" 2 => "G.M. Rauch" 3 => "E. Arribas" 4 => "R. Kanagal-Shamanna" 5 => "M.W. Clemens" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10549-014-3034-3" "Revista" => array:6 [ "tituloSerie" => "Breast Cancer Res Treat" "fecha" => "2014" "volumen" => "147" "paginaInicial" => "1" "paginaFinal" => "14" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25073777" "web" => "Medline" ] ] ] ] ] ] ] ] 50 => array:3 [ "identificador" => "bib0515" "etiqueta" => "51" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Breast implant-associated anaplastic large cell lymphoma: clinical and imaging findings at a large US cancer center" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "B.Z. Dashevsky" 1 => "K.M. Gallagher" 2 => "A. Grabenstetter" 3 => "P.G. Cordeiro" 4 => "A. Dogan" 5 => "E.A. Morris" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/tbj.13161" "Revista" => array:6 [ "tituloSerie" => "Breast J" "fecha" => "2019" "volumen" => "25" "paginaInicial" => "69" "paginaFinal" => "74" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30521149" "web" => "Medline" ] ] ] ] ] ] ] ] 51 => array:3 [ "identificador" => "bib0520" "etiqueta" => "52" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Use of 18F-fludeoxyglucose positron emission tomography-CT in the management of breast implant-associated anaplastic large cell lymphoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "S. Ladani" 1 => "K. Valassiadou" 2 => "Y. Griffin" 3 => "F. Miall" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1259/bjrcr.20150424" "Revista" => array:5 [ "tituloSerie" => "BJR case Rep" "fecha" => "2016" "volumen" => "2" "paginaInicial" => "20150424" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30459981" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735107/0000006200000004/v2_202009020633/S2173510720300434/v2_202009020633/en/main.assets" "Apartado" => array:4 [ "identificador" => "45683" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Update in Radiology" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735107/0000006200000004/v2_202009020633/S2173510720300434/v2_202009020633/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173510720300434?idApp=UINPBA00004N" ]
