Clinicopathologic Characterization of Post-Renal Transplantation BK Polyomavirus-Associated Urothelial Carcinoma: Single Institutional Experience

Objectives: To review rare cases of BK polyomavirus (BKPyV) associated urologic carcinomas in kidney transplant recipients at one institution and in the literature. Methods: We describe the clinicopathologic features of BKPyV-associated urologic carcinomas in a single-institution cohort. Results: Am...

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Bibliographic Details
Published in:American journal of clinical pathology 2020-03, Vol.153 (3), p.303
Main Authors: Chu, Ying-Hsia, Zhong, Weixiong, Rehrauer, William, Pavelec, Derek M, Ong, Irene M, Arjang, Djamali, Patel, Sanjay S, Hu, Rong
Format: Article
Language:English
Subjects:
Cancer
Carcinoma
Diagnosis
Kidneys
Polyoma virus
Statistics
Transplantation
Urinary tract cancer
Virus diseases
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Summary:Objectives: To review rare cases of BK polyomavirus (BKPyV) associated urologic carcinomas in kidney transplant recipients at one institution and in the literature. Methods: We describe the clinicopathologic features of BKPyV-associated urologic carcinomas in a single-institution cohort. Results: Among 4,772 kidney recipients during 1994 to 2014, 26 (0.5%) and 26 (0.5%) developed posttransplantation urothelial carcinomas (UCs) and renal cell carcinomas (RCCs), respectively, as of 2017. Six (27%) UCs but none of the RCCs expressed large T antigen (TAg). TAg-expressing UCs were high grade with p16 and p53 overexpression (P < .05 compared to TAg-negative UCs). Tumor genome sequencing revealed BKPyV integration and a lack of pathogenic mutations in 50 cancer-relevant genes. Compared to TAg-negative UCs, TAg-expressing UCs more frequently presented at advanced stages (50% T3-T4) with lymph node involvement (50%) and higher UC-specific mortality (50%). Conclusions: Post-renal transplantation BKPyV-associated UCs are aggressive and genetically distinct from most non-BKPyV-related UCs. Key Words: BK polyomavirus; Urothelial carcinoma; Transplantation
ISSN:0002-9173
DOI:10.1093/AJCP/AQZ167