BK Virus–Associated Urothelial Carcinoma of a Ureter Graft in a Renal Transplant Recipient: A Case Report

Oikawa, Masaaki; Fujita, Takeshi; Murakami, Reiichi; Hagiwara, K.; Narita, Takuma; Noro, Daisuke; Tanaka, Toshikazu; Tanaka, Yoshimi; Tobisawa, Yuki; Yoneyama, T.; Yoneyama, Takahiro; Hashimoto, Y; Koie, Takuya; Narumi, Shunji; Οhyama, Chikara

doi:10.1016/j.transproceed.2013.09.037

Cited by 23 publications

(25 citation statements)

References 27 publications

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“…In contrast to the somewhat frequent detection of BKV in bladder cancers from transplant recipients, BKV is present only rarely in bladder cancers that arise in the general population (34, 37). Among other urothelial cancers in transplant recipients, five additional cases of BKV detection have been described, including four of the allograft renal pelvis and, one involving the transplant ureter (17, 19–21, 30). Cancers of the renal pelvis and ureter were too rare to analyze separately in our study, but there was no indication of an association with tBKVN.…”

Section: Discussionmentioning

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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Section: Discussionmentioning

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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“…Urothelial carcinoma associated with BK nephropathy after kidney transplant has been described. 53 Additionally, literature suggests that ureteral stenting during kidney transplant increases the risk of polyomavirus BK viremia and viruria. 54 OTHER UROLOGIC CONSIDERATIONS IN THE KIDNEY TRANSPLANT RECIPIENT UTI in transplant recipients is established with urine culture and treated with antibiotic therapy.…”

Section: Immunosuppressionmentioning

confidence: 99%

Urologic Considerations and Complications in Kidney Transplant Recipients

Carlo

Darras

2015

Advances in Chronic Kidney Disease

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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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BK Virus–Associated Urothelial Carcinoma of a Ureter Graft in a Renal Transplant Recipient: A Case Report

Cited by 23 publications

References 27 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

Urologic Considerations and Complications in Kidney Transplant Recipients

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

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