- Paper Type: Review
- Please cite as: Cantwell AR Jr. Pleomorphic
Bacteria as a Cause of Hodgkin's Disease (Hodgkin's lymphoma): A Review
of the Literature. JOIMR 2006;4(1):1
- Published: 21 February 2006
- (C) 2006, by Alan Cantwell, Jr. M.D.
- Hodgkin's disease (HD) is widely considered
a neoplastic disease. However, for more than a century some investigators
have considered HD an infectious disease, caused by pleomorphic bacteria
closely related to the mycobacteria that cause tuberculosis. A recent report
showing "intracellular bacteria" in HD, as well as a previous
electron microscopic study showing intra- and extracellular "microorganism-like
structures," adds credence to the idea that bacteria are associated
with HD. This communication provides a review of the largely forgotten
literature pertaining to the complex microbiology of HD. Microphotographs
of cell wall deficient and mycoplasma-like intracellular and extracellular
forms, observed in vivo in acid-fast stained microscopic tissue sections
of HD, are also presented, as previously reported.
- Bacteria in Hodgkin's Disease
- Hodgkin's disease was first described
in 1832 by Thomas Hodgkins. For more than a century HD was not considered
a cancer, but was widely regarded as a bacterial and infectious disease,
possibly related to tuberculosis.
- The cause of HD is unknown. However,
over the past century there have been various reports implicating "pleomorphic"
bacteria, possibly derived from the so-called "acid-fast" (red-staining)
mycobacteria that cause tuberculosis. Pleomorphic bacteria are capable
of assuming different shapes and sizes. Bacteria observed and cultured
from HD are most commonly described as intermittently acid-fast round coccus
forms resembling common staphylococci; and rod-shaped bacteria known as
corynebacteria (also called "diphtheroid" bacteria and "propionibacteria")
- Hodgkin's Disease Coexisting with
- HD is considered a form of cancer affecting
the lymphatic system, usually beginning as a painless swelling of lymph
glands (nodes). Later stages of the disease include fever, persistent fatigue,
weight loss, itching, and night sweats. Some of these clinical signs resemble
those of tuberculosis (TB).
- A definitive diagnosis of HD is made
by the pathologist based on the type of cell found on biopsy. A distinct
kind of cell (the so-called "Reed-Sternberg cell") is a hallmark
of this cancer. Carl Sternberg himself claimed in 1898 that HD was caused
by TB bacteria; and Dorothy Reed noted the frequent association of tuberculosis,
even finding TB and HD in the same lymph node, as quoted by Stewart .
- HD and tuberculosis can coexist in the
same patient. A recent report of a Polish case concluded "the association
between HD and TB must be considered, especially in countries where the
latter is endemic. The diagnosis may be difficult due to similarities in
the clinical course, laboratory tests and imaging procedures" .
- HD can also coexist with sarcoidosis,
a disease often affecting the lungs and lymph nodes and long thought to
also have a close relationship with TB and TB bacteria . Lymph nodes
draining cancer can occasionally show evidence of sarcoidosis.
- Recent observations suggest a closer
association between HD and "non-Hodgkin's lymphoma" than previously
recognized . There are about 8000 cases of HD diagnosed yearly in the
U.S.; and 55,000 cases of non-Hodgkin's. Various pathological types of
"B-cell" and "T-cell" non-Hodgkin's lymphoma can be
further divided and classified into aggressive and non-aggressive, and
slow and fast-growing types. Each type of lymphoma looks slightly different
under a microscope and each carries a different prognosis.
- "T-cell lymphoma of the skin"
is also known as mycosis fungoides; and HD and mycosis fungoides may also
coexist together in the same patient . Pleomorphic acid-fast bacteria
similar to those found in HD have also been reported in mycosis fungoides
and non-Hodgkin's lymphoma, by Busni [1-2], Aplas [13-14], and Cantwell
- HD is also closely related to leukemia
 and Kaposi's sarcoma . French physician Georges Mazet found acid-fast
bacteria in the blood of leukemia cases in 1962 . AIDS patients have
an increased incidence of both Hodgkin's and non-Hodgkin's lymphoma, as
well as a high incidence of Kaposi's sarcoma . Pleomorphic acid-fast
bacteria have been observed in AIDS-related lymphoma and Kaposi's sarcoma
by Cantwell et al. [21-24].
- Before chemotherapy and radiation treatments
were designed for HD, the disease was uniformly fatal. Now the 5-year survival
rate is about 80%. However, the patient may play a heavy price healthwise
for this standard therapy. Patients who survive radiation treatment for
HD can develop a second related cancer. According to Aisenberg, deaths
from second malignancies are the most important cause of death other than
HD itself .
- A recent study points to radiation as
causing women survivors of HD to have up to a 40 percent greater risk for
breast cancer . HD patients are also at increased risk for acute leukemia
and non-Hodgkin's lymphoma. University of Texas Southwestern Medical Center
researchers have found that patients surviving childhood Hodgkin's disease
suffer strokes later in life at rates about four times that of the general
population. They suspect the radiation used in treating this cancer as
a cause .
- Because the cause of all these different
cancers is unknown, it is assumed there is no etiologic connection between
them. However, cancer microbe research suggests that infectious pleomorphic
bacteria (and virus-like forms of bacteria) are implicated in many forms
- The Microbiology of Cancer
- The microbiology of Hodgkin's disease
is intimately connected with the microbiology of cancer. The reason for
this is that similar bacteria, primarily in the coccus-like form in microscopic
tissue sections, are found in various forms of cancer. In addition, similar
microbes have been observed in non-cancerous diseases, such as sarcoidosis,
lupus erythematosus, scleroderma, and others [6, 27-31].
- Microbiologist Lida Mattman, in Cell
Wall Deficient Forms: Stealth Pathogens, presents detailed information
on the possible role of pleomorphic bacteria in cancer. A chapter in her
book ("Microbes and Malignancies") contains an excellent single
source of reference material to the microbiology of cancer. Mattman cites
dozens of researchers dating back to 1910 who wrote about pleomorphic bacteria
in HD. 
- Important and long-forgotten contributions
to the bacterial etiology of cancer were made in the 1920s by Scottish
obstetrician James Young [33-34], Montana surgeon Michael Scott [35-36],
and Chicago surgeon John Nuzum , all of whom consistently found pleomorphic
microbes, characterized by cocci and unusual stages of growth in culture.
- The leading proponents of the bacteriology
of cancer in the last half century are Virginia Wuerthele-Caspe Livingston,
M.D. , microbiologist Eleanor Alexander-Jackson , cell cytologist
Irene Diller [40-41], and noted biochemist Florence Seibert [42-43]. Their
work is documented in Livingston's Cancer: A New Breakthrough  and
The Conquest of Cancer ; and in my books, The Cancer Microbe ,
and Four Women Against Cancer . Color photographs of Cantwell's cancer
bacteria are published on-line at the Journal of Independent Medical Research
- During the 1970s and 1980s I identified
bacteria in acid-fast stained tissue sections from HD patients, carefully
studied by use of the ordinary light microscope, using the oil immersion
lens at a magnification of 1000 times. Microphotographs of bacteria in
tissue sections of the heart, lung, lymph nodes, skin, pancreas, cerebrum,
bone and marrow from four HD patients, were reported in 1981, along with
a review of the literature showing bacteria in HD [7-8].
- In 1979 I encountered a 56-year-old white
man with a rare HD tumor initially confined to the skin. Intracellular
and extracellular coccoid forms were identified in the deep layers of the
skin; and Propionibacterium acnes - a rod-shaped bacterium with acid-fast
granules was cultured from the skin tumor. Later that year the patient
developed new swellings of lymph nodes diagnosed microscopically as HD.
Similar coccoid forms were seen in the node. Despite radiation therapy
and chemotherapy, he died the following year from cardiac arrest. At autopsy,
the heart showed changes consistent with "radiation pericarditis."
Rare foci of scattered acid-fast coccoid forms were noted in the lung and
heart. There was no autopsy evidence of HD. However, microbes were present
in the lung tissue sections, as reported in 1984, by Cantwell and Kelso
- Pleomorphic bacteria cultured from HD
and cancer have a "life cycle" that does not conform to the strict
laws of microbiology. Various forms include cocci and rods, larger round
forms similar to yeasts and spores, and fungus-like forms [33-37]. In addition,
there are smaller, mycoplasma-like forms, and filter-passing virus-like
submicroscopic forms .
- Of special interest is the cancer research
undertaken in the late nineteenth century by Scottish pathologist William
Russell, who described variably-sized pleomorphic round forms (some as
large as red blood cells) in cancer tissue, which he believed represented
"the parasite of cancer" [48-49]. These forms are now well-known
to pathologists as "Russell bodies." Although the exact nature
of Russell bodies remains an enigma, pathologists do not interpret them
as microbial in origin . It is my belief that they represent the large
round forms of coccoid bacteria which have lost their cell wall and have
become "mycoplasma-like." Similar-appearing large bacterial forms
of cell wall deficient bacteria in culture are known to bacteriologists
as "large bodies."
- According to noted microbiologist Louis
Dienes, "large bodies" are the connecting link between pleomorphic
bacteria and cell wall deficient "L-forms" (also known as mycoplasma)
. Due to the loss of a bacterial cell wall, large bodies vary in size
and can enlarge in culture (in vitro) up to 50 micron in size. These large
forms are many times larger than the standard size of ordinary bacterial
cocci. The largest forms are known as "giant large bodies." Large
body forms of bacteria may be what Russell observed in cancer and tuberculosis
tissue (in vivo) and interpreted as "parasites." Cantwell reported
"large bodies" in scleroderma and pseudoscleroderma . Variably-sized
"eosinophilic bodies," frequently found in the tissue of AIDS-related
Kaposi's sarcoma, may also represent large bodies .
- Russell's "cancer parasites"
may also relate to the cancer microbe research of Dr. Doyen, a French surgeon
who routinely cultured coccoid forms from various cancers for fourteen
years, also in the late nineteenth century. A brief note on his research
("Dr. Doyen and the microbe of cancer") appears on pages 126-27
in the Jan 11, 1902, issue of The Lancet, which states, "The microbe
appears in the forms of motile diplococci, one coccus of which is sometimes
four or five times as big as the other." Doyen called his cancer microbe
"micrococcus neoformans," and like "Russell's parasite"
is long forgotten.
- Bacteria as a Cause of Hodgkin's Disease
- Could the entire medical establishment,
except for a few dissidents, be wrong in completely rejecting a bacterial
cause of HD for more than a century?
- In 2005 the Nobel Prize in medicine was
given to two Australian researchers, microbiologist Barry J Marshall and
pathologist J Robin Warren, who discovered that stomach ulcers were caused
by bacteria that millions of people carry normally in their stomach. For
a century these bacteria, now identifiable in tissue with a special tissue
stain, went undetected by physicians, all of whom were taught that bacteria
could not live in the acid environment of the stomach. Now a curative antibiotic
treatment has been designed to treat Helicobacter pylori infection. We
also now recognize that chronic infection with helicobacteria can lead
to stomach cancer, and also to a lymphoma cancer of the stomach, known
as "MALT-lymphoma" (mucosa-associated lymphoid tissue lymphoma).
- Closely allied to the microbiology of
cancer is recent research showing that human blood is not sterile. On the
contrary, bacteriologists have discovered that human blood normally contains
various species of bacteria, such as staphylococci, corynebacteria, and
others, some of which are acid-fast [54-58]. There may prove to be an intimate
connection between bacteria in the blood and bacteria in cancer; and the
blood bacteria may also prove to be the origin of such bacteria.
- In 1975, using the electron microscope,
Parmley et al. showed "microorganism-like structures" in lymph
nodes in some untreated patients with HD. These round forms with "internal
composition" were found within and outside of the cells and resembled
mycoplasma and cell wall deficient bacteria, suggesting "subclinical
- More recently, Swiss oncologist Christian
Sauter and pathologist Michael Kurrer discovered "intercellular rods"
and "spheres" in six HD patients, by use of a special PAS stain,
a traditional stain used to detect fungal infection of tissue . They
note that many features of HD suggest a bacterial infection; and that the
epidemiology of HD also suggests a bacterial disease like TB. Sauter and
Blum have also recently noted regression of HD of the lung by use of prolonged
antibiotic therapy with ciprofloxacin and clarithromycin .
- Sauter and his colleagues hypothesize
that the development of HD may be similar to cancer in plants, whereby
a plant bacterium called Agrobacterium tumefaciens exchanges genetic material
with plant cells to cause plant crown gall tumors. Their "crown gall"
hypothesis for Hodgkin's disease would explain the clinical observations
of a bacterial infection that behaves like a malignant tumor. Sauter thinks
antibiotic treatment of very early Hodgkin's disease may be successful
before there is a genetic exchange between the bacteria and human cells.
- Microphotographs of Bacteria in Hodgkin's
- Unlike extremely small submicroscopic
viruses, HD bacteria are large enough to be observed by use of the conventional
light microscope. Therefore, bacteria can be observed in-vivo in microscopic
examination of cancerous tissue.
- Virginia Livingston made a valuable contribution
to the microbiology of cancer by stressing that the acid-fast stain is
the key to the identification and demonstration of the microbe both in
tissue (in vivo) and in culture (in vitro). Lida Mattman's seminal research
delineating the various forms comprising the "life cycle" of
cell wall deficient bacteria, particularly TB-causing mycobacteria, are
essential contributions to identifying microbes in cancer [62-63].
- In addition, Anna Csillag has shown that
there is a "mycococcus form" of acid-fast mycobacteria. This
small round coccus is an inherent and stable part of the life cycle of
mycobacteria . Mycococcal forms greatly resemble micrococci and staphylococci
and are similar in size and shape to the coccoid forms regularly seen in
vivo in acid-fast stained tissue sections of HD and cancer.
- When searching for TB mycobacteria, pathologists
generally search for acid-fast red-stained rod-shaped forms of the TB germ.
They ignore other growth forms of the tubercle bacillus, which are the
round coccal forms. These forms are not acid-fast. Thus, "atypical"
forms of TB bacteria and other microbes can go unrecognized in diseased
- The microphotographs accompanying this
article clearly show round intra- and extracellular elements in vivo that
appear as bacteria. What is the evidence that such forms are bacteria?
First of all, as mentioned, cocci have been cultured from Hodgkin's disease
and non-Hodgkin's lymphoma by various cancer researchers. Secondly: these
coccoid forms in vivo have the size and shape of cocci cultured in the
laboratory (in vitro) from HD. They stain like microbes, grow and multiply
like bacteria, have the appearance of pleomorphic microbes, invade the
cell like bacteria, and kill like bacteria.
- For a century it has been noted that
"normal" lymph nodes may harbor bacteria. Thus, it may be argued
that the finding of bacteria in lymph nodes of HD might be discounted for
this reason. However, the same appearing microbes in the nodes of HD were
also present found in the skin tumors of HD and in other organs and throughout
the connective tissue at autopsy. The widespread presence of these coccoid
forms strongly suggests the microbe is involved in the pathogenesis of
- Figures 1-3 show coccoid forms in the
skin and lymph node of a previously reported 56 year-old man with HD of
the skin and lymph node . Figures 4 and 5 show the appearance of the
microbe (Propionibacterium acnes) grown from the skin tumor, when stained
with the acid-fast stain and also with the ordinary Gram's stain used for
bacteria. Figure 6 shows the variably-sized round coccoid and spore-like
forms seen in the lungs at autopsy from a reported fatal case of HD in
a 15 year-old Latina . Figure 7 shows larger round forms in a lymph
node from Hodgkin's disease, consistent with the appearance of Russell
- Microphotographs of Russell's bodies
in HD have been reported by Cantwell . Additional photos of Russell
bodies in Hodgkin's disease can be found on the Internet by Googling: Russell
Body + Alan Cantwell.
- Is There a Specific Bacterial Agent
in Hodgkin's Disease?
- After a century of bacteriologic study
of HD it is clear that there is no specific species of microbe connected
with the disease. However, in my view, all cultural isolates showing cocci
and pleomorphic forms should be carefully considered as etiologic suspects,
particularly if the cancerous tissue sections show pleomorphic forms in
- In my experience cultures from cancer
often appear as common staphylococci, such as S. epidermidis; or as common
corynebacteria. All cultures should be examined for acid-fastness; and
cultures should be examined and re-examined over a period of time, rather
than being discarded after several days, as is the case with most "routine"
- All tissue specimens should be examined
with an acid-fast stain, as that is the staining procedure that offers
the best overall staining of these bacteria. Acid-fast rod forms are extremely
rare; intra- and extracellular coccoid and granular forms are the common
forms. "Large bodies" can occasionally be observed, suggesting
that the cancer microbe exists in vivo in HD in the cell wall deficient
phase or mycoplasma-like phase. Due to their size, the largest pleomorphic
bacterial forms may be easily confused with fungal spores and yeasts.
- For almost a half century the late physician
Milton W White was convinced that a pleomorphic fungus caused cancer. In
his last communication in 2002 he referred to the cancer agent as an "intracellular
invasive microbe." He termed the coccoid forms as "seeds"
of an "invasive asexual spore" related to fungi . Abstracts
of White's numerous papers on his cancer-causing "mycococcus,"
published in Medical Hypothesis, can be found at the PubMed website.
- Most cancer microbe researchers believe
the cancer microbe is a bacterium. However, years ago I observed in bacterial
cultures from scleroderma that the initial cocci and rod forms of the microbe
became more fungus-like as it aged . The exact identification of this
fungus could not be ascertained, even though my professor, J Walter Wilson,
M.D., was one of the world's leading fungal experts. In my experience,
scleroderma and cancer microbes are closely related to the acid-fast mycobacteria.
And bacteriologists all agree that mycobacteria are closely related to
the fungal-like "actinomycetes." The word "myco" is
Greek for fungus, thus emphasizing their close relationship.
- The Peculiar Microbiology of Hodgkin's
- The wide range of bacterial forms found
in HD in the early twentieth century was reviewed in 1933 by Andrew Wallhauser,
M.D., who cited reports of acid-fast bacteria, streptococci in the blood,
various types of cocci, a large diplococcus, Staphylococcus albus [now
called S. epidermidis], "curious bodies resembling the spores of fungus,"
diphtheroid bacteria (now known also as corynebacteria and propionibacteria),
and filterable forms called the "tuberculosis virus," and others
- Of particular interest was the HD research
of Natalia Busni of the University of Odessa in the Ukraine, recorded in
the German literature in 1928 and 1931 [1-2]. She reported a peculiar organism
in 5 cases of mycosis fungoides (T cell lymphoma of the skin) and 140 cases
of "lymphogranulomatosis" (an older synonym for HD and also for
sarcoidosis). The bacteria initially cultured from HD showed TB-like acid-fast
rod forms, but after 24 hours the rods completely transformed to cocci,
resembling common staphylococci, as quoted by Steiner  . Busni's coccus
did not return to the acid-fast rod form in vitro in the lab, but had to
be passed through an animal before it could be recovered again in its initial
acid-fast rod form. Busni regarded mycosis fungoides and lymphoma as closely
related, and considered them both as bacteremias (blood infections). Busni's
coccus and its derivation from acid-fast rod-shaped bacteria is reminiscent
of Anna Csillag's non-acid-fast "mycococcus" derived from acid-fast
- Although such microbes are still looked
upon with disbelief by many bacteriologists, this pleomorphism is consistent
with bacteria cultured and studied by various cancer microbe researchers
over the past century. Busni's work showing acid-fast bacteria in HD was
later confirmed by Aplas in a series of papers (1959-1963) in the German
literature [13-14], and by Cantwell in 1982 [6-8].
- The pleomorphic microbe of cancer cannot
be easily "classified" because it defies the laws of microbiology.
As stated, traditional microbiologists and pathologists do not believe
in "life cycles" for bacteria.
- The famous Russian microbiologist N A
Krasilnikov, in his seminal book, Soil Microorganisms and Higher Plants,
remarks about the classification of bacteria, particularly the "actinomycetes"
(the bacteria-like and fungal-like microbes), to which the HD microbe (and
the cancer microbe) is closely related. He writes:
- The classification of microorganisms
is very unsatisfactory. There is no common principle of classification
in microbiology. The classification of bacteria and actinomycetes is especially
inadequate. This can be explained by the peculiarity of those organisms,
the simplicity of their structure and growth and lack of external properties
- The bacteria of the genus Micrococcus
are characterized by their spherical shape. Into this group organisms which
in fact belong to coccoid bacteria are included and also not infrequently
specimens of actinomycetes are included in the genus Mycococcus.
- The shortcomings of the bacteriological
classification have their origin in our scant knowledge of the life of
the organisms. In order to be able to speak of the phylogenetic relations
between the organisms, it is not sufficient to know and study one randomly
chosen stage of the life cycle of the microbe. A thorough knowledge of
its growth, development, structure, reproduction, life cycle, polymorphism,
variability, etc, is needed. In order to obtain much knowledge, the organism
in question should be studied not only in laboratory conditions but also
in natural surroundings. (italics Cantwell)
- The lack of knowledge of the life cycle
of this or another microbe frequently misleads the investigator. For example
for this reason mycobacteria are considered by some authors as micrococci
or as rodlike bacteria.Krasinikov's full treatise is available free on-line
in the Library section at www.soilandhealth.org.
- Cancer, and the "Human-Bacteria
- Most people do not envision the human
body as immersed in a sea of microbes from internal and external sources.
Our only protection from the trillions of potentially dangerous bacteria
that inhabit our bodies is our immune system and the grace of God, for
want of a better phrase.
- There is also recent evidence that bacteria
and human cells constantly "swap genes", much like the AIDS retrovirus
swaps its genetic material with human cells. Rowan Hooper, writing in Wired
News about new research at Imperial College London, notes: "Most of
the cells in your body are not your own, nor are they even human. They
are bacterial. From the invisible strands of fungi waiting to sprout between
our toes, to the kilogram of bacterial matter in our guts, we are best
viewed as walking 'superorganisms,' highly complex conglomerations of human
cells, bacteria, fungi and viruses. More than 500 different species of
bacteria exist in our bodies, making up more than 100 trillion cells. Because
our bodies are made of only some several trillion human cells, we are somewhat
outnumbered by the aliens. It follows that most of the genes in our bodies
are from bacteria, too. Luckily for us, the bacteria are on the whole commensal,
sharing our food but doing no real harm."
- Some physicians might expect a cancer
germ to be a specific kind and species of bacterium, but there is no reason
why this should be the case. Physicians also expect an antibiotic (and
radiation) to kill cancer bacteria, when, in fact, cancer bacteria cannot
be eradicated so easily. Doctors expect a cancer germ to be present in
cancer patients, but not in cancer-free patients. However, Virginia Livingston
and others carefully noted that everyone carries cancer germs. This is
not unlike the millions of healthy Americans who carry antibiotic-resistant
staphylococci in the nose, the same bacteria that in other people can cause
death-threatening infections unresponsive to any available antibiotic therapy.
Or normal, healthy people who carry cancer-causing bacteria in the stomach.
- I am aware of microbiologists and pathologists
who demand "proof" that these round forms are microbes. However,
I contend that after attending medical school physicians should be able
to recognize bacteria when they see them. And surely these "forms"
reported for a century should be recognized as significant and studied
carefully. The disinterest of the medical and microbiologic community in
investigating bacteria in HD and other forms cancer is not in the tradition
of good science.
- There is no longer any excuse to be ignorant
of research pointing to bacteria as a possible cause of cancer, particularly
when evidence of such bacteria resides in the medical literature. Previously,
the contents of medical journals were closed to most people who could not
gain entrance to a medical library. By use of Internet search engines and
the PubMed website, published medical literature is now easily available
to everyone via the click of a mouse.
- A computer Internet search, using key
words such as: cancer microbe, cancer bacteria, pleomorphism, and nanobacteria
+ cancer, provides a good introduction to the microbiology of cancer. In
addition, I suggest Googling cancer research workers, such as Virginia
Livingston, Erik Enby, Guenther Enderlein, Alan Cantwell, Lida Mattman,
Wilhelm Reich + T Bacilli, Raymond Royal Rife, and others.
- The cancer microbe has a rich history
dating back to the nineteenth century. Anyone interested in the bacterial
cause of cancer and certain other diseases of unknown etiology would be
well advised to explore it.
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