Duct Bellini carcinoma in association with BK virus nephropathy after lung transplantation

Dufek, Stephanie; Haitel, Andrea; Müller-Sacherer, Thomas; Aufricht, Christoph

doi:10.1016/j.healun.2012.11.033

Cited by 27 publications

(22 citation statements)

References 4 publications

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“…Two cases were poorly differentiated RCCs and two were collecting duct carcinomas, one each of a native kidney and a transplanted kidney; additional details on the clinical and pathologic features of these cases are provided in the published reports. [38][39][40][41] In our study, the four kidney cancers in recipients with tBKVN for which we had data were all diagnosed in the native kidney.…”

Section: Discussionmentioning

confidence: 96%

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: 96%

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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“…PyVAN was detected in a 67‐year‐old female recipient 60 months after LuT . Recently, a case of BKPyV‐associated cancer has been reported in a paediatric LuT recipient who first was diagnosed with PyVAN at 2 years post‐transplant leading to end‐stage renal failure and then was diagnosed with ductus Bellini carcinoma of the native kidney .…”

Section: Post‐transplant Hpyv Assessment and Management Of Sot Recipimentioning

confidence: 99%

European perspective on human polyomavirus infection, replication and disease in solid organ transplantation

Hirsch

Babel

Comoli

et al. 2014

Clinical Microbiology and Infection

122

121

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Human polyomaviruses (HPyVs) are a growing challenge in immunocompromised patients in view of the increasing number of now 12 HPyV species and their diverse disease potential. Currently, histological evidence of disease is available for BKPyV causing nephropathy and haemorrhagic cystitis, JCPyV causing progressive multifocal leukoencephalopathy and occasionally nephropathy, MCPyV causing Merkel cell carcinoma and TSPyV causing trichodysplasia spinulosa, the last two being proliferative skin diseases. Here, the current role of HPyV in solid organ transplantation (SOT) was reviewed and recommendations regarding screening, monitoring and intervention were made. Pre-transplant screening of SOT donor or recipient for serostatus or active replication is currently not recommended for any HPyV. Post-transplant, however, regular clinical search for skin lesions, including those associated with MCPyV or TSPyV, is recommended in all SOT recipients. Also, regular screening for BKPyV replication (e.g. by plasma viral load) is recommended in kidney transplant recipients. For SOT patients with probable or proven HPyV disease, reducing immunosuppression should be considered to permit regaining of immune control. Antivirals would be desirable for treating proven HPyV disease, but are solely considered as adjunct local treatment of trichodysplasia spinulosa, whereas surgical resection and chemotherapy are key in Merkel cell carcinoma. Overall, the quality of the clinical evidence and the strength of most recommendations are presently limited, but are expected to improve in the coming years.

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“…The reported malignancies in this setting have comprised a spectrum of high-grade urothelial carcinomas, collecting duct carcinomas, and renal cell carcinomas occurring up to several years post-transplant [9,11,12]. The tumors have occurred primarily in donor kidneys, and in one instance in a native kidney [13], and have demonstrated diffuse expression of the viral large Tantigen by immunohistochemistry. In SV-40 transgenic mice, morphologically similar tumors are thought to arise through inactivation of p53 and Rb protein by the viral large T-antigen leading to uncontrolled cell proliferation [14,15], although evidence of such a mechanism in human tumors is still lacking.…”

Section: Introductionmentioning

confidence: 99%

Polyoma virus-associated carcinomas of the urologic tract: a clinicopathologic and molecular study

Sirohi

Vaske²,

Sanborn³

et al. 2018

Modern Pathology

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In recent years, there has been increased interest in carcinomas of the urologic tract, that demonstrate association with the polyoma virus BK arising in immunosuppressed individuals, though the nature of this association is uncertain. To begin to understand this phenomenon, we reviewed the clinical, morphological, and immunohistochemical features of 11 carcinomas of the urologic tract, mainly urothelial (N = 9) and collecting duct carcinomas (N = 2), occurring during immunosuppression, and expressing polyoma virus T-antigen by immunohistochemistry. These were compared to a control group of carcinomas (N = 8), also arising during immunosuppression, but without T-antigen expression. A subset of both groups were also studied by hybrid capture-based DNA sequencing, probing not only for 479 cancer-related human genes, but also for polyoma and other viral sequences. Polyoma T-antigen-expressing tumors arose in 7 males and 4 females, at a median age of 66, and were aggressive, high-grade tumors with more than 1 variant morphologic pattern identified in 81% of cases, and a majority (73%) presenting at high stage category (>pT3). Diffuse polyoma T-antigen staining was seen in 91% of cases, with co-localization of aberrant p53 staining in 89%. Sequencing detected a lower number of deleterious mutations among T-antigen-expressing cases (average 1.62; 1/8 with TP53 mutation) compared to control cases (average 3.5, 2/4 with TP53 mutation). Only BK virus was detected with clonal integration and breakpoints randomly distributed across the human and viral genomes in 5/5 of the polyoma T-antigen-expressing carcinomas, and in none of the controls (0/4). In summary, these findings identify aggressive clinicopathologic features of polyoma T-antigen-expressing carcinomas, document BK as the strain involved, and associate BK viral integration with T-antigen expression and p53 aberrancy. While the apparent randomness of viral insertion sites is functionally unclear, the differing rates of mutations between T-antigen-expressing and control cases is intriguing.

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Duct Bellini carcinoma in association with BK virus nephropathy after lung transplantation

Cited by 27 publications

References 4 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

European perspective on human polyomavirus infection, replication and disease in solid organ transplantation

Polyoma virus-associated carcinomas of the urologic tract: a clinicopathologic and molecular study

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