High‐grade urothelial carcinoma in a kidney transplant recipient after JC virus nephropathy: The first evidence of JC virus as a potential oncovirus in bladder cancer

Kidney transplant (KT) recipients have an increased risk for urothelial carcinoma. A role for JC virus (JCV) in human cancers is not yet proved but there is an increasingly reported association between BK virus (BKV) nephropathy and renourinary neoplasms. We report a KT recipient who developed a hig...

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Bibliographic Details
Published in:	American journal of transplantation 2020-04, Vol.20 (4), p.1188-1191
Main Authors:	Querido, Sara, Fernandes, Isabel, Weigert, André, Casimiro, Sandra, Albuquerque, Catarina, Ramos, Sância, Adragão, Teresa, Luz, Ivan, Paixão, Paulo, Chasqueira, Maria, Santos, Madalena, Machado, Domingos
Format:	Article
Language:	eng
Subjects:	Antigen T (large) BK Virus - genetics cancer Carcinoma, Transitional Cell Cell cycle clinical research Deoxyribonucleic acid DNA DNA, Viral - genetics histopathology Humans infection and infectious agents – viral infection and infectious agents – viral: BK JC Virus - genetics kidney disease: infectious Kidney transplantation Kidney Transplantation - adverse effects Kidneys Malignancy neoplasia: metastatic disease neoplasia: risk factors nephrology Nephropathy p53 Protein pathology Polymerase chain reaction polyoma Polyomavirus Infections - complications practice Retroviridae Transplants & implants Tumor Virus Infections Urinary Bladder Neoplasms - etiology urology Urothelial carcinoma Urothelium VP1 protein
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Summary:	Kidney transplant (KT) recipients have an increased risk for urothelial carcinoma. A role for JC virus (JCV) in human cancers is not yet proved but there is an increasingly reported association between BK virus (BKV) nephropathy and renourinary neoplasms. We report a KT recipient who developed a high‐grade urothelial carcinoma 5 years after a diagnosis of JCV nephropathy and 9 years after kidney transplantation. Neoplastic tissue was positive for JCV DNA by real‐time polymerase chain reaction (PCR). Immunochemical staining showed strong positivity for cell cycle markers (p16, p53, and Ki67) and for early viral protein JCV large T antigen (JCV LTag; using a broad polyomavirus antibody); however, late viral protein (VP1) stained negative. In contrast, in non‐neoplastic urothelium, JCV DNA and all immunochemical markers were negative. These facts suggest that malignancy was induced by JCV. To the best of our knowledge, this is the first report of urothelial high‐grade carcinoma associated with JCV nephropathy in a KT recipient. The authors present a patient with high‐grade urothelial carcinoma, 5 years after the diagnosis of biopsy‐proven JC virus nephropathy and 9 years after kidney transplantation.
ISSN:	1600-6135 1600-6143