Chlamydia Infection and Lymphomas: Association Beyond Ocular Adnexal Lymphomas Highlighted by Multiple Detection Methods

Abstract

Purpose: Chlamydia psittaci (Cp) has been associated to ocular adnexal lymphomas (OAL) with variable geographic distribution. Herein, we used multiple Chlamydia detection tools to identify Cp elementary bodies^containing cell and to assess Cp prevalence in both nodal and extranodal lymphomas. Experimental Design: TETR-PCR, immunohistochemistry, immunofluorescence, electron microscopy, and laser-capture microdissection were done in 35 OALs to define their effect in Chlamydia detection and, moreover, to identify the Cp cellular carrier. Cp prevalence was screened byTETR-PCR in 205 extraorbital lymphomas and 135 nonneoplastic controls. Results: Twenty-six (74%) OALs were associated with Cp infection: immunohistochemistry, immunofluorescence, and laser-capture microdissection-assisted PCR showed that monocytes/ macrophages were the Cp carriers; electron microscopy showed the presence of intact Cp elementary bodies into these cells. Immunohistochemistry andTETR-PCR showed a 70% concordance rate (P = 0.001). Cp DNA was equally prevalent in non-OAL, nodal, and extranodal lymphomas: among the latter, it was more common in diffuse large B-cell lymphomas of the skin (P = 0.03) and Waldeyer's ring.Conclusions: This multiparametric approach shows, for the first time, that monocytes/macrophages are the carriers of Cp, Cp seems preferentially associated with lymphomas arising in organs primarily exposed to antigens. The clinical implications of these findings deserve to be prospectively investigated.

Chronic inflammatory disease, lymphoid tissue neogenesis and extranodal marginal zone B-cell lymphomas

“…56,[88][89][90] Immunohistochemistry, laser assisted microdissection PCR and electron microscopy further provided evidence that C. psittaci was present in monocytes/macrophages within the MZBCL. 91 Moreover, C. psittaci was cultured in vitro from conjuctival swabs and/or PBMCs from 25% of ocular adnexal MZBCL patients. 92 However, the association between C. psittaci and ocular adnexal MZBCL could not be confirmed in studies from The Netherlands, Japan and The United States (Florida), suggesting geographical differences regarding this link.…”

Role of Chlamydia in the Development of Ocular Adnexal Lymphoma

“…Overall, these findings suggest that the variability of the prevalence rated worldwide may be affected not only by geographical differences but also by the different sensitivity of the methods used for sample collection, PCR analysis and sequence diversity in the target region of C. psittaci [66,89,90].…”

An Atypical Association of Hepatitis C Infection With Extranodal Marginal Zone Lymphoma

“…He was discharged home with a plan to follow-up with oncology and gastroenterology for initiation of chemotherapy and treatment of hepatitis C infection. [3][4][5][6].…”