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Pulmonary mucosa-associated lymphoid tissue lymphoma revisited

Raphael Borie, Marie Wislez, Martine Antoine, Christiane Copie-Bergman, Catherine Thieblemont, Jacques Cadranel
European Respiratory Journal 2016 48: 1252; DOI: 10.1183/13993003.01143-2016
Raphael Borie
1Service de Pneumologie A, Centre de compétences maladies pulmonaires rares, AP-HP, Hôpital Bichat, Paris, France
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Marie Wislez
2Service de Pneumologie, Centre de compétences maladies pulmonaires rares, AP-HP, Hôpital Tenon, Paris, France
3GRC-THERANOSCAN, Université P&M Curie, Université Paris 6, Paris, France
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Martine Antoine
3GRC-THERANOSCAN, Université P&M Curie, Université Paris 6, Paris, France
4Service d'Anatomie pathologique, AP-HP, Hôpital Tenon, Paris, France
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Christiane Copie-Bergman
5AP-HP, Groupe Henri Mondor-Albert Chenevier, Département de Pathologie, Creteil, France
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Catherine Thieblemont
6Service d'Hémato-oncologie, AP-HP, Hôpital Saint-Louis, - Université Diderot, Sorbonne Paris Cité, Paris, France
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Jacques Cadranel
2Service de Pneumologie, Centre de compétences maladies pulmonaires rares, AP-HP, Hôpital Tenon, Paris, France
3GRC-THERANOSCAN, Université P&M Curie, Université Paris 6, Paris, France
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  • For correspondence: jacques.cadranel@aphp.fr
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Abstract

Is there a pathogen associated with pulmonary MALT lymphoma? http://ow.ly/Ki8I302UVxX

From the authors:

We thank E. Catherinot and colleagues for their comments and the additional data they provided to our recent review on pulmonary mucosa-associated lymphoid tissue (MALT) lymphoma [1]. Using 16S ribosomal DNA PCR, they did not find any traces of DNA from mycobacteria in eight samples of pulmonary MALT lymphoma. They only found DNA from environmental bacteria and Propionibacterium acnes, both in MALT lymphoma and control samples.

Since the discovery of Helicobacter pylori in gastric MALT lymphoma, to find a pathogen associated with pulmonary MALT lymphoma appeared to be the quest for the holy grail [2]. However, numerous questions have to be answered before to succeed.

1) On which samples should we work? Not only lymphoma specimens but also peri-tumoural lesions have to be included in the molecular analysis, as tumoural cells are not infected by H. pylori in gastric lymphoma.

2) Are there different kinds of pulmonary MALT lymphomas? In pulmonary MALT lymphoma, being a rare disease, it is challenging to individualise pathophysiological subgroups. However, we probably need to make a case-by-case analysis of patients when retrieving the results of microbiological analysis. We maybe have to get back to clinical (context or not of autoimmune disease), and histological and molecular (presence of not of gene rearrangement) characteristics when looking for a subgroup of patients within pulmonary MALT lymphomas.

3) As usual, a control group is mandatory. E. Catherinot and colleagues chose to include “normal lung” and lung cancer in their study. Other pulmonary diseases, such as granulomatous or idiopathic interstitial lung diseases, should be tested as well as specimens from other, nonpulmonary MALT lymphoma.

4) Finally – and this is probably the crux of the problem – what method should be used? As suggested by E. Catherinot and colleagues, a nontargeted approach, with next-generation DNA sequencing, should be considered. However, methods are continuously changing at almost every steps of analysis and negative or positive results should then be carefully discussed.

In this context, regrouping our strengths could help to answer to this apparently simple but still unresolved question.

Footnotes

  • Conflict of interest: Disclosures can be found alongside this article at erj.ersjournals.com

  • Received June 9, 2016.
  • Accepted July 11, 2016.
  • Copyright ©ERS 2016

References

  1. ↵
    1. Borie R,
    2. Wislez M,
    3. Antoine M, et al.
    Pulmonary mucosa-associated lymphoid tissue lymphoma revisited. Eur Respir J 2016; 47: 1244–1260.
    OpenUrlAbstract/FREE Full Text
  2. ↵
    1. Parsonnet J,
    2. Hansen S,
    3. Rodriguez L, et al.
    Helicobacter pylori infection and gastric lymphoma. N Engl J Med 1994; 330: 1267–1271.
    OpenUrlCrossRefPubMedWeb of Science
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Pulmonary mucosa-associated lymphoid tissue lymphoma revisited
Raphael Borie, Marie Wislez, Martine Antoine, Christiane Copie-Bergman, Catherine Thieblemont, Jacques Cadranel
European Respiratory Journal Oct 2016, 48 (4) 1252; DOI: 10.1183/13993003.01143-2016

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Pulmonary mucosa-associated lymphoid tissue lymphoma revisited
Raphael Borie, Marie Wislez, Martine Antoine, Christiane Copie-Bergman, Catherine Thieblemont, Jacques Cadranel
European Respiratory Journal Oct 2016, 48 (4) 1252; DOI: 10.1183/13993003.01143-2016
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