Campylobacter Jejuni Infection In Intestinal Lymphoma: A Strong Association With Immunoproliferative Small Intestinal Disease.

Abstract Immunoproliferative small intestinal disease (IPSID) is a lymphoma of the mucosa-associated lymphoid tissue (MALT) that produces a characteristic truncated immunoglobulin α-heavy chain. Bacterial involvement is suspected in this disease, as some tumours resolve after antibiotic treatment and other MALT lymphomas have proven associations with infectious agents. A recent report implicated Campylobacter jejuni in the development of IPSID. In this study, we used a PCR based method to identify C. jejuni in paraffin embedded archival material of intestinal lymphomas. The cases studied included IPSID, other non-IPSID MALT lymphomas, mantle cell lymphomas (MCL), diffuse large B-cell lymphomas (DLBCL), follicular lymphomas (FL) and enteropathy-type T-cell lymphomas (ETTL) as well as inflammatory diseases such as Crohn’s disease and coeliac disease. Campylobacter specific 16S ribosomal DNA (16S rDNA) was amplified by PCR and the products were sequenced to confirm Campylobacter sequences and to classify Campylobacter species. The results are summarised in Table 1. Campylobacter 16S rDNA was amplified from 11/22 IPSID samples and from 12/121 other samples including 6/11 DLBCL. The sequence analysis showed that, in IPSID, the sequences were mostly specific for C. Jejuni whereas generic sequences consistent with several other Campylobacter species were obtained in other lymphomas. The IPSID cases originated from a very wide range of geographical locations suggesting that the association with C.jejuni was disease specific rather than environmental. Our results confirm a close association between C.jejuni infection and IPSID but also suggest that Campylobacter sequences can be found in other intestinal lymphomas, in particular DLBCL. Table 1 Diagnosis 16S rDNA (VC6) C jejuni C jejuni or related Not sequenced IPSID 11/22 7 2 2 MCL 2/8 0 2 0 DLBCL 6/11 0 4 2 MALT 1/15 0 0 1 FL 0/13 0 0 0 ETTL 0/5 0 0 0 Crohn’s 0/12 0 0 0 Coeliac 1/13 0 0 1 Others 2/44 2 0 0 TOTAL 23/143 9 8 6