Prevalence of Borrelia Burgdorferi Infection in a Series of 98 Primary Cutaneous Lymphomas

Abstract

Borrelia burgdorferi has been variably associated with different forms of primary cutaneous lymphoma. Differences in prevalence rates among reported studies could be a result of geographic variability or heterogeneity in the molecular approaches that have been employed. In the present study, we investigated the prevalence of Borrelia burgdorferi sensu lato DNA in diagnostic tissue samples from fresh cutaneous biopsies of 98 primary cutaneous lymphomas and 19 normal skin controls. Three different polymerase chain reaction (PCR) protocols targeting the hbb, flagellin, and Osp-A genes were used. Direct sequencing of both sense and antisense strands of purified PCR products confirmed the specificity of the amplified fragments. Sequence specificity was assessed using the Basic Local Alignment Search Tool, and MultAlin software was used to investigate the heterogeneity of target gene sequences across the different samples.Borrelia DNA was not detected in 19 controls, 23 cases of follicular lymphoma, 31 cases of extranodal marginal zone lymphoma, or 30 cases of mycosis fungoides. A single case of 14 diffuse large B-cell lymphoma cases was positive for B. burgdorferi.This study does not support a pathogenic role of B. burgdorferi in primary cutaneous B-and T-cell lymphomas from areas nonendemic for this microorganism and the consequent rationale for the adoption of antibiotic therapy in these patients. The Oncologist 2011;16:1582-1588

Antibiotic therapy in nongastrointestinal MALT lymphoma: a review of the literature

“…12 In analogy with geographic incidence variations of CP positivity in OAMZL, endemic as well as nonendemic regions have been defined for this pathogen. Areas seen as endemic, such as the Scottish Highlands or Austria, have demonstrated up to 40% Borrelia infection in cutaneous marginal-zone lymphomas, 12,27 whereas in a large Italian series by Ponzoni et al, 28 no association was observed. In addition, a series of 60 cases of primary cutaneous marginal-zone lymphoma collected in Germany, Asia, and the United States found no evidence for Borrelia infection.…”

Early lymphoid lesions: conceptual, diagnostic and clinical challenges

“…80 However, other studies, including those from regions where Borrelia is common, have not confirmed this finding. 81,82 PCMZL presents as solitary or multiple papules/nodules most often in the upper extremities, and is usually not seen in the head and neck. Plasmacytoid differentiation is common.…”

Pathologic Diagnosis of Cutaneous Lymphomas

“…In certain areas of Europe, PCMZL is rarely associated with Borrelia burgdorferi infection, but this link has not been found in PCMZL from Asia and the United States. [87][88][89] In plasma cell predominate variants (primary cutaneous plasmocytoma, immunocytoma), other differential diagnoses have to be considered. Secondary cutaneous plasmocytoma could be excluded by staging procedures.…”