Risk of malignant lymphoma in patients with previous tuberculosis infection: a cohort study

Tuberculosis (TB) is associated with chronic inflammation, which has been implicated in the pathogenesis of various malignancies, including lung cancer. However, the relationship between TB and hematological malignancies like lymphoma remains less understood. This study aimed to investigate risks of incident malignant lymphoma according to previous TB infection in a large prospective cohort of 347,204 individuals. Multiple logistic regression analyses were conducted to predict the probability of malignant lymphoma. Propensity score matching was employed to compare the incidence of lymphoma in individuals with and without previous TB infection. Among the overall population, 3.7% (12,694) reported previous history of TB. There was a significantly increased risk of lymphoma in individuals with a TB history, with an odds ratio of 2.14 (95% confidence interval (CI): 1.35–3.39, p = 0.001) and a hazard ratio of 2.13 (95% CI, 1.13–4.00; p = 0.019) in propensity-matched analyses. These findings underscore TB infection as a potential precursor to lymphoma, probably due to prolonged inflammatory and immune dysregulation. The study highlights the importance of considering a TB history in the risk assessment for lymphoma, emphasizing the need for vigilant clinical monitoring in population with high TB burden.