Fig. 4.

Steps for proper handling and processing of capsules and implants with suspicion of breast implant anaplastic large cell lymphoma. a En bloc resection of capsule containing the implant. Note the specimen is oriented by the surgeon: Long stitches denote lateral margin; short stitches denote the superior margin. b Preoperatively the presence of peri-implant effusion was determined. A 50-mL syringe allows aspiration of the fluid/effusion, as noted in the inset, to be sent for cytopathology and flow cytometry immunophenotype analyses. c Incision on the posterior surface, from lateral to medial allows visualization of remnants of fluid and implant. Additional vertical incisions (interrupted lines) allows for a better exposure of the luminal surface of the capsule. d Implant in situ with opened capsule displaying the luminal surface. e Detachment of implant. f Flat-opened capsule displaying the luminal surface