Clinicopathologic Characterization of Post–Renal Transplantation BK Polyomavirus-Associated Urothelial CarcinomaSingle Institutional Experience. Issue 3 (19th October 2019)

• Record Type: Journal Article
• Authors: Chu, Ying-Hsia; Zhong, Weixiong; Rehrauer, William; Pavelec, Derek M; Ong, Irene M; Arjang, Djamali; Patel, Sanjay S; Hu, Rong
• Is Part Of: American journal of clinical pathology. Volume 153:Issue 3(2020)
• Page Start: 303
• Page End: 314
• Publication Date: 2019-10-19
• Subjects: BK polyomavirus -- Urothelial carcinoma -- Transplantation; Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqz167
• Languages: English
• ISSNs: 0002-9173

Abstract

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.