BK Virus-Associated Invasive Urothelial Carcinoma With Prominent Micropapillary Carcinoma Component in a Cardiac Transplant Patient: Case Report and Review of Literature

Lavien, Garjae; Alger, Jordan; Preece, Janae; Alexiev, Borislav A.; Alexander, Richard B.

doi:10.1016/j.clgc.2015.04.008

Cited by 9 publications

(9 citation statements)

References 18 publications

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“…13 Over the last few years, Merkel cell polyomavirus has been demonstrated to be the causative agent for the majority of Merkel cell carcinomas in humans. 15 Notably, BKV has been linked to aggressive urinary tract cancers in kidney transplant recipients in a large number of recent case reports, [16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] as summarized by Papadimitriou et al 35 These reports provide evidence of BKV in the tumors as demonstrated by immunohistochemical staining for BKV proteins, polymerase chain reaction (PCR) testing for BKV DNA, or detection of chromosomally integrated BKV through whole-genome shotgun sequencing of the tumor.…”

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confidence: 99%

Treatment for presumed BK polyomavirus nephropathy and risk of urinary tract cancers among kidney transplant recipients in the United States

Gupta

Kuppachi

Kalil

et al. 2018

American Journal of Transplantation

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Recent case series describe detection of BK polyomavirus (BKV) in urinary tract cancers in kidney transplant recipients, suggesting that BKV could contribute to the development of these cancers. We assessed risk for urinary tract cancers in kidney recipients with or without treatment for presumed BKV nephropathy (tBKVN) using data from the United States Transplant Cancer Match Study (2003-2013). Among 55 697 included recipients, 2015 (3.6%) were reported with tBKVN. Relative to the general population, incidence was similarly elevated (approximately 4.5-fold) for kidney cancer in recipients with or without tBKVN, and incidence was not increased in either group for prostate cancer. In contrast, for invasive bladder cancer, incidence was more strongly elevated in recipients with versus without tBKVN (standardized incidence ratios 4.5 vs. 1.7; N = 48 cases), corresponding to an incidence rate ratio (IRR) of 2.9 (95% confidence interval [CI] 1.0-8.2), adjusted for sex, age, transplant year, and use of polyclonal antibody induction. As a result, recipients with tBKVN had borderline increased incidence for all urothelial cancers combined (renal pelvis, ureter, and bladder cancers: adjusted IRR 2.2, 95% CI 0.9-5.4; N = 89 cases). Together with reports describing BKV detection in tumor tissues, these results support an association between BKV and urothelial carcinogenesis among kidney transplant recipients.

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confidence: 99%

Treatment for presumed BK polyomavirus nephropathy and risk of urinary tract cancers among kidney transplant recipients in the United States

Gupta

Kuppachi

Kalil

et al. 2018

American Journal of Transplantation

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“…However, the most serious complication of BKV in these patients is the development of urologic malignancies. Fortunately, such complications are rare and only 36 cases of urothelial carcinoma (UC) (Table ), and several renal cell carcinomas, including collecting duct carcinomas were reported to date …”

Section: Discussionmentioning

confidence: 99%

Unusual BK polyomavirus‐associated urologic malignancies in renal transplant recipients: Report of two cases and review of the literature

Odetola

Isaila

Pambuccian

et al. 2018

Diagnostic Cytopathology

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Renal transplant recipients are at increased risk of developing urologic malignancies, some of which are associated with prolonged BK virus infection. We report two cases of BK virus-associated carcinoma with variant morphological patterns (clear cell adenocarcinoma of the bladder and micropapillary urothelial carcinoma of the pelvicaliceal system) arising in the urinary tract of renal transplant recipients. In both cases, the diagnosis was initially established on cytologic specimens: on urine cytology in one patient and on fine needle aspiration of an inguinal lymph node in the other patient. The unusual cytologic features of both cases (multiple morphologies in one patient and micropapillary pattern in the other), co-occurrence of decoy cells in the urine of one patient and the occurrence of these tumors in renal transplant recipients raised the possibility of BK polyomavirus-associated malignancy and led to confirmatory SV40 immunostains that were positive. These cases expand the morphologic variants of BK virus-associated urologic malignancies diagnosed in solid organ transplant patients. While differentiating BK virus-infected cells from malignant cells in urine cytology specimens is a diagnostic challenge, greater awareness of their possible co-existence is vital, as this could be the only chance for an early diagnosis.

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“…The potential role of BKV infection in tumorigenesis has received great attention[ 187 - 248 ]. Urothelial malignancies in association with BKV infection were described in several recipients of kidney transplants[ 200 , 205 , 213 , 214 , 216 , 220 - 223 , 227 , 229 , 233 , 234 , 236 , 238 , 239 , 245 , 247 ] and one heart transplant recipient[ 243 ]. Malignancies in non-transplanted subjects in which BK infection may play a pathogenetic role include bladder carcinoma [ 201 , 211 ], renal cell carcinoma[ 192 , 230 ], prostatic carcinoma[ 212 , 217 , 235 , 245 ], Kaposi’s sarcoma[ 197 ], neuroblastoma[ 199 ], leukemia, non-Hodgkin’s lymphoma[ 205 ], colorectal carcinoma[ 215 ], gastrointestinal B-cell lymphoma[ 240 ], oral squamous cell carcinoma[ 244 ], cervical carcinoma[ 224 ], breast carcinoma[ 226 ] and melanoma[ 206 ].…”

Section: Bkv Infections In Other Populationsmentioning

confidence: 99%

BK nephropathy in the native kidneys of patients with organ transplants: Clinical spectrum of BK infection

Vigil

Konstantinov

Barry

et al. 2016

WJT

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Nephropathy secondary to BK virus, a member of the Papoviridae family of viruses, has been recognized for some time as an important cause of allograft dysfunction in renal transplant recipients. In recent times, BK nephropathy (BKN) of the native kidneys has being increasingly recognized as a cause of chronic kidney disease in patients with solid organ transplants, bone marrow transplants and in patients with other clinical entities associated with immunosuppression. In such patients renal dysfunction is often attributed to other factors including nephrotoxicity of medications used to prevent rejection of the transplanted organs. Renal biopsy is required for the diagnosis of BKN. Quantitation of the BK viral load in blood and urine are surrogate diagnostic methods. The treatment of BKN is based on reduction of the immunosuppressive medications. Several compounds have shown antiviral activity, but have not consistently shown to have beneficial effects in BKN. In addition to BKN, BK viral infection can cause severe urinary bladder cystitis, ureteritis and urinary tract obstruction as well as manifestations in other organ systems including the central nervous system, the respiratory system, the gastrointestinal system and the hematopoietic system. BK viral infection has also been implicated in tumorigenesis. The spectrum of clinical manifestations from BK infection and infection from other members of the Papoviridae family is widening. Prevention and treatment of BK infection and infections from other Papovaviruses are subjects of intense research.

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BK Virus-Associated Invasive Urothelial Carcinoma With Prominent Micropapillary Carcinoma Component in a Cardiac Transplant Patient: Case Report and Review of Literature

Cited by 9 publications

References 18 publications

Treatment for presumed BK polyomavirus nephropathy and risk of urinary tract cancers among kidney transplant recipients in the United States

Treatment for presumed BK polyomavirus nephropathy and risk of urinary tract cancers among kidney transplant recipients in the United States

Unusual BK polyomavirus‐associated urologic malignancies in renal transplant recipients: Report of two cases and review of the literature

BK nephropathy in the native kidneys of patients with organ transplants: Clinical spectrum of BK infection

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