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C. Chan, J.A. Smith, D. Shen, R.A. Ursea, H.E. Grossniklaus; Molecular Signatures of Helicobacter Pylori (H. pylori) in Conjunctival Mucosa-Associated Lymphoid Tissue (MALT) Lymphoma . Invest. Ophthalmol. Vis. Sci. 2003;44(13):2437.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose:Conjunctival MALT lymphoma is an extranodal margional zone B-cell lymphoma. The exaggerated clonal expansion of B cells that characterizes MALT lymphoma implicates a pathological proliferative response to one or few dominant antigens including bacteria. Helicobacter pylori has been proposed as one of the causative agents of gastric MALT lymphoma; however, it has not been previously reported in extragastric MALT lymphoma. We examined 4 cases of conjunctival MALT lymphoma for H. pylori genes. Methods:Four patients (3 adults and 1 child) presented with salmon-colored conjunctival lesions. One patient also had a history of bone marrow biopsy one year earlier showing lymphoid aggregates involving 5% or less of the overall bone marrow. The conjunctival lesions of these 4 patients were biopsied or excised. Histopathological diagnoses were consistent with conjunctival MALT lymphoma. Lymphoma and normal conjunctival cells on the paraffin sections were separately microdissected using laser capture microscopy, PixCell II (Arcturus) or a 30-gauge needle under the microscope. DNA was extracted and subjected to PCR amplification using H. pylori gene-specific primers of HPU54 and HPU18 from the urease B gene (J Clin Microbiol 1992;30:192). Conjunctival lesions from a case of chronic conjunctivitis (normal lymphocytes) and human T-cell lymphotropic virus type-1/adult T-cell leukemia/lymphoma (HTLV-1/ATL) were also microdissected, processed and analyzed as the controls. Results:Polymerase chain reaction demonstrated the presence of H. pylori urease B DNA in the conjunctival MALT lymphoma cells of 3/4 cases. The negative case was the one with a history of abnormal bone marrow. In contrast, H. pylori DNA was not detected in normal conjunctival cells from the cases of MALT lymphoma or the lymphocytes and ATL cells from the two controls. Conclusions: H. pylori genes have been detected by PCR in conjunctival MALT lymphoma cells. Helicobacter infection may play a pathologic role in the development of conjunctival MALT lymphoma. H. pylori eradication therapy may be useful in the managementof MALT lymphoma.
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