Ocular adnexal lymphoma of MALT-type and its association with chlamydophila psittaci infection

Abstract

Ocular adnexal marginal zone lymphoma (OAMZL) presents as an indolent and generally limited-stage disease that involves conjunctiva, eyelid, lachrymal gland and sac, or orbit soft tissue; standard treatments are not well defined, and include wait and watch policy, radiotherapy or other topic approach, and also chemotherapy. The development of OAMZL has been linked to Chlamydophila psittaci (Cp) infection. Chlamydiae are obligate intracellular bacteria that grow in eukaryotic cells and cause a wide spectrum of diseases. They can establish persistent infections, are mitogenic in vitro, promote cell proliferation in vivo and induce resistance to apoptosis in infected cells. Cp determines both local and systemic infections in these patients, and bacterial eradication with antibiotic therapy is often followed by lymphoma regression. Despite the recent advances in the understanding of this bacterium-lymphoma association, several questions remain unanswered. Variations among different geographic areas and related diagnostic and therapeutic implications remain a major investigational issue. We focus on clinical features of OAMZL, standard treatments, Cp-infection and its therapeutic implications in lymphomas.