Positive serology for Lyme disease Borrelias in primary cutaneous B-cell lymphoma: a study in 22 patients; is it a fortuitous finding?

Abstract

In conclusion there appears to be a clustering of positive serology for Lyme disease Borrelias in PCBCL patients possibly related to an ethiopathogenic relationship. Mechanisms of Borrelia escape from immunosurveillance mechanisms, persistence of both their mitogenic and antigenic stimuli for B-cells, and SALT formation may be involved in the pathogenesis of a subset of PCBCL.

The non-Hodgkin lymphomas: A review of the epidemiologic literature

“…B. burgdorferi, a tick-borne spirochete that causes Lyme disease, 606 has been linked with cutaneous lymphoma based on elevated antibody titers to this organism. [607][608][609] A causative role of B. burgdorferi in cutaneous lymphoma has not been established, however, as evidence has been inconsistent. In a Lyme disease-endemic area of Scotland, B. burgdorferi-specific DNA was detected in 7 out of 20 primary cutaneous B-cell lymphoma (PCBCL) cases and one of 40 control patients (p < 0.05).…”

“…In a Lyme disease-endemic area of Scotland, B. burgdorferi-specific DNA was detected in 7 out of 20 primary cutaneous B-cell lymphoma (PCBCL) cases and one of 40 control patients (p < 0.05). 609 B. burgdorferi was present in 18% of patients with PCBCL in an Austrian study. 611 Munksgaard et al, 612 using data from the US SEER program and the CDC, failed to demonstrate a geographic correlation between Lyme disease incidence rates and PCBCL, suggesting that B. burgdorferi is not a major risk factor for PCBCL in the US.…”

Infectious Agents as Causes of Non-Hodgkin Lymphoma

“…More recently, several studies have linked three other sitespecific MALT NHLs with bacteria causing chronic local infections: small intestine NHL with Campylobacter jejuni, ocular adnexa NHL with Chlamydia psittaci, and cutaneous NHL with Borrelia afzelii (a European agent of Lyme's disease; refs. [24][25][26]. These initial observations await confirmation and extension, although the work is made difficult by the rarity of these NHLs.…”

Cutaneous and systemic Lyme disease

“…A prolonged Borrelia infection may cause chronic lymphatic stimulation, which subsequently leads to developing slow growing, poorly defined erythematous nodules and tumors on the skin. In European studies, there is evidence of a positive association between Lyme borreliosis, in particular, the strain B. afzelii, and malignant cutaneous lymphomas [43][44][45][46][47][48][49] that demonstration has failed in North America [50] and Asia [51]. Differences in B. burgdorferi strains between different endemic regions may provide the explanation; B. afzelii appears to be the predominant strain in Europe, while B. burgdorferi ss is more common in North America [52].…”