Clinicopathologic Characterization of Post–Renal Transplantation BK Polyomavirus-Associated Urothelial CarcinomaSingle Institutional Experience

Abstract 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. Resu...

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Bibliographic Details
Published in:American journal of clinical pathology 2020-02, Vol.153 (3), p.303-314
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:
Adult
Aged
BK Virus
Bladder cancer
Carcinoma, Renal Cell - etiology
Carcinoma, Renal Cell - pathology
Carcinoma, Transitional Cell - etiology
Carcinoma, Transitional Cell - pathology
Female
Genomes
Humans
Kidney - pathology
Kidney cancer
Kidney Neoplasms - etiology
Kidney Neoplasms - pathology
Kidney transplantation
Kidney Transplantation - adverse effects
Lymph nodes
Male
Middle Aged
p53 Protein
Polyomavirus Infections - etiology
Polyomavirus Infections - pathology
Postoperative Complications - etiology
Postoperative Complications - pathology
Renal cell carcinoma
Retrospective Studies
Transplants & implants
Tumor Virus Infections - etiology
Tumor Virus Infections - pathology
Urothelial carcinoma
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Summary:Abstract 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.
ISSN:0002-9173
1943-7722
DOI:10.1093/ajcp/aqz167