Absence of Borrelia burgdorferi DNA in cutaneous B-cell lymphomas from theUnited States

Background: An association between Borrelia burgdorferi and cutaneous B-cel l lymphoma (CBCL) has been made in several European countries. The evidence in favor of such an association has recently been based on more definitive tests for the pathogenetic role of B. burgdorferi in CBCL, including posit ive cultures or polymerase chain reaction (PCR) amplification of borrelial DNA from lesional skin. However, there is only one report of B. burgdorferi in four North American cases of B-cell lymphoma. Methods: We retrieved 38 cases of primary and secondary CBCL from different geographic regions of the United States. Two separate techniques were used to detect borrelial DNA by PCR, a nested PCR method to amplify a B. burgdo rferi-specific gene as well as a borrelial chromosomal Ly-l clone amplifica tion method. Southern blot hybridization was used for confirmation of the P CR results. Results: No B. burgdorferi-specific DNA was detected in any of the 38 CBCL cases, whereas detectable PCR products were obtained with our positive cont rols. Conclusions: Our findings, in light of previous studies, suggest that B. bu rgdorferi plays a minimal role in the development or pathogenesis of CBCL i n the United States. The findings also suggest that the geographic variatio ns in the clinical manifestations of B. burgdorferi are indeed real and may be secondary to the genetic and phenotypic differences between B. burgdorf eri strains present in Europe and North America. (C) Munksgaard 2001.