<i>Achromobacter</i> Infection Is Rare in Japanese Patients with Pulmonary B-cell Lymphoma

Abstract

Objective Achromobacter xylosoxidans (A. xylosoxidans) has been recently reported to have an association with the development of pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma in patients from European countries. However, the prevalence rates for A. xylosoxidans may vary significantly from country to country. To assess this association, the prevalence of A. xylosoxidans was analyzed in Japanese patients with pulmonary B-cell lymphoma. Methods DNA samples were obtained from formalin-fixed, paraffin-embedded sections of pulmonary MALT lymphomas (n=52), diffuse large B-cell lymphomas (DLBCLs, n=18), and benign pulmonary lesions (n=19). All samples were histopathologically reviewed by experienced hematopathologists, and the clonality of all MALT lymphoma cases was confirmed by a polymerase chain reaction (PCR)-based IGH rearrangement clonality assay. They were also tested for the API2-MALT1 fusion transcript. The presence of bacterial DNA was assessed with a nested PCR, and DNA sequencing was performed to confirm the PCR specificity. Results A. xylosoxidans DNA was detected in 1/52 cases of pulmonary MALT lymphoma, 2/18 cases of DLBCL, and 0/19 cases of benign pulmonary lesions. The prevalence of A. xylosoxidans in pulmonary lymphoma was not significantly higher than in benign lesions. Conclusion The present study shows that A. xylosoxidans infection may not be associated with pulmonary B-cell lymphoma in a Japanese case series. Large-scale international studies are needed to clarify the role of A. xylosoxidans in pulmonary lymphoma.

Primary Pulmonary B-Cell Lymphoma: A Review and Update

“…Adam et al reported on patients affected by PP-MZL from six European countries, and detected Achromobacter xylosoxidans , a Gram-negative aerobic motile bacterium, which is an opportunistic pathogen with low virulence and antibiotic-resistance, typically present in patients with cystic fibrosis [ 22 ]. Although these results suggest a strong association between A. xylosoxidans infection and MALT lymphomagenesis, findings from a Japanese study are contradictory [ 23 ], describing a low prevalence of this bacterium in lung biopsies from patients affected by PP-MZL assessed by PCR-based analysis. Conversely, in this study A. xylosoxidans was more frequent in biopsies from patients with DLBCL.…”

“…Conversely, in this study A. xylosoxidans was more frequent in biopsies from patients with DLBCL. Such conflicting findings may be partly due to the heterogeneous geographic distribution of this bacterium, resulting in a higher incidence of cystic fibrosis in Western countries [ 23 ]. Other studies describe a correlation between Mycobacterium tuberculosis infection and the development of PP-MZL, claiming that patients with active tuberculosis not adequately managed by antituberculosis drugs may have an increased risk of developing lymphoma over time, since activated macrophages and T-cells are capable to stimulate clonal proliferation of B lymphocytes [ 24 ].…”

Current Status of the Spectrum and Therapeutics of Helicobacter pylori-Negative Mucosa-Associated Lymphoid Tissue Lymphoma

“…Patients with pulmonary MALT lymphoma frequently present with an asymptomatic and indolent disease course, and most patients are diagnosed during an annual checkup [ 20 , 22 , 67 ]. Unlike the close association between bacterial infections and IPSID, OAML, and cutaneous MALT lymphoma, the association between Achromobacter xylosoxidans and pulmonary MALT lymphoma is controversial [ 68 , 69 , 70 ]. Adam et al first reported that the prevalence of A. xylosoxidans was higher in tumor samples from patients with pulmonary MALT lymphoma than in lung tissues of control cases from six European countries (46.0% (57/124) vs. 18.3% (15/82), p = 0.004) through a specific nested PCR approach for the DNA of A. xylosoxidans [ 68 ].…”

Impact of the microenvironment on the pathogenesis of mucosa-associated lymphoid tissue lymphomas

“…Other infectious associations have been reported for Borrelia burgdorferi (skin)[ 31 ], Campylobacter jejuni (intestine)[ 32 ], Achromobacter xylosoxidans (lung)[ 33 ], Chlamydia psittaci (ocular, nongastrointestinal MALT lymphomas)[ 34 - 36 ] and hepatitis C virus (splenic marginal zone lymphoma)[ 37 ]. The strength of these associations shows vast geographical discrepancies[ 38 - 40 ]. In addition, an association of MALT lymphomas with chronic inflammation induced by autoimmune disease is found in primary Sjögren’s syndrome (pSS)[ 41 - 43 ] and Hashimoto thyroiditis[ 44 ].…”