Polyoma (BK) virus associated urothelial carcinoma originating within a renal allograft five years following resolution of polyoma virus nephropathy

Salvatore, Steven; Myers-Gurevitch, Patricia M; Chu, Stacy; Robinson, Brian D.; Dadhania, Darshana; Seshan, Surya V.

doi:10.5414/cn108410

Cited by 18 publications

(22 citation statements)

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“…Tumour tissue was positive for simian virus 40 (SV40) large T antigen. The case demonstrates the possible association of persistent subclinical BKV infection in the graft with the development of malignant transformation of epithelial cells, despite the disappearance of BKV viraemia 46 . Although there is an increasing amount of data demonstrating a possible relationship between BKV infection and the development of malignancy, the carcinogenic potential of BKV remains unclear.…”

Section: Clinical Manifestationmentioning

confidence: 86%

BK virus-induced renal allograft nephropathy

Krejčí¹,

Tichý²,

Bednaříková³

et al. 2018

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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BK virus nephropathy (BKVN) is a serious opportunistic infection threatening renal function especially during the first year after transplantation. Its incidence is now on the rise and is closely related to the level of the recipient's immune system inhibition. This is more intensive with current trends in transplantation medicine, where more potent immunosuppressive protocols are used and more aggressive antirejection therapy is applied. In the absence of BK virus (BKV) specific therapy and limited treatment options for advanced BKVN, active screening of BKV replication and subsequent preemptive adjustment of immunosuppression are essential measures to prevent BKVN. However, it remains unclear how to modify immunosuppressive protocols as well as how to address initial stages of BKV replication. This comprehensive review summarizes the currently applied and not completely uniform procedures for the detection, prophylaxis and therapy of BKV replication and BKVN. The pitfalls brought by reduced immunosuppression, as a typical response to a significant viral replication or a developed BKVN, are also mentioned, particularly in the form of graft rejection. The paper also outlines the authors' experiences, and lists currently ongoing studies on the subject. The perspectives of new, especially immune-based, procedures in the treatment of complications associated with BKV infections are highlighted. Different views on the management of patients indicated for kidney re-transplantation whose previous graft failed because of BKVN are also discussed.

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Section: Clinical Manifestationmentioning

confidence: 86%

BK virus-induced renal allograft nephropathy

Krejčí¹,

Tichý²,

Bednaříková³

et al. 2018

Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub

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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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“…UC could arise in the ureter and pelvicalyceal system, which are also lined with transitional epithelium. 3,4 Urothelial carcinoma is associated with a number of risk factors and specifically with aristolochic acid exposure 5 and cigarette smoking. 1 Urothelial carcinoma has also been reported in renal transplant recipients (RTRs), predominantly occurring in the native urinary tract.…”

Section: Introductionmentioning

confidence: 99%

“…2 These are typically associated with poor outcome-a likely consequence of immunosuppression, along with the increased risk of malignancy in general related to infectious disease, such as BK virus (BKV). 3,4 Urothelial carcinoma is associated with a number of risk factors and specifically with aristolochic acid exposure 5 and cigarette smoking. 6 Exposure to large doses of compound analgesics is associated with end stage renal failure and also UUC.…”

Section: Introductionmentioning

confidence: 99%

Urothelial carcinoma arising from the transplanted kidney: A single‐center experience and literature review

Bellini

Gopal

Hill

et al. 2019

Clinical Transplantation

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Urothelial carcinoma (UC) is a malignancy predominantly arising in the bladder. Upper tract UC (UUC) is uncommon, accounting only for 5-10% of the cases. High incidence of neoplasms is associated with immunosuppressive therapy; thus, UCs of the transplanted grafts often lead to a more aggressive treatment, in order to withdraw completely the immunosuppression. It significantly affects the patient quality of life, meaning return to dialysis, along with the worse life expectancy. We present our single-institution experience of this rare malignancy in two mid-age kidney transplant recipients, with UCs successfully treated with radical nephroureterectomy: G3 pT3 N0 + G3 pT1 N0 in the first patient and G3 pT2 N0 in the second one. We also review the previous literature focusing on stage of presentation and treatment for the affected kidney transplant patients. K E Y W O R D Sgraft nephrectomy, immunosuppression, kidney transplant, malignancy, urothelial carcinoma

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Polyoma (BK) virus associated urothelial carcinoma originating within a renal allograft five years following resolution of polyoma virus nephropathy

Cited by 18 publications

References 0 publications

BK virus-induced renal allograft nephropathy

BK virus-induced renal allograft nephropathy

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

Urothelial carcinoma arising from the transplanted kidney: A single‐center experience and literature review

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