BK polyomavirus and urothelial carcinoma: Experience at a tertiary care centre in India with review of literature

Ann Diagn Pathol. 2019 Jun:40:77-80. doi: 10.1016/j.anndiagpath.2019.04.006. Epub 2019 Apr 23.

Abstract

Introduction: BK polyomavirus is ubiquitous and remains dormant in the urothelial tract, reactivating and replicating in the immunocompromised state especially in the setting of post-renal transplantation where it is believed to be directly oncogenic based on recent reports. Its oncogenic role in the immunocompetent host is controversial. This study aimed to investigate the association of BK polyomavirus in Urothelial Carcinoma.

Material and methods: Patients with suspected urothelial carcinoma (UC) admitted under Department of Urology over a period of one year were recruited and transuretheral bladder tumor (TURBT) resection was performed, along with sampling of cystoscopically normal-appearing urothelium away from the tumor. In addition, cystectomy specimens with UC were included, with sampling of grossly normal-appearing urothelium away from the tumor. Immunohistochemistry (IHC) for SV40 T-Antigen and chromogenic in situ hybridization (CISH) using BK polyomavirus specific probe was performed on the paired samples (tumor and normal).

Results: Twenty-three TURBT and 14 cystectomy specimens were assessed. None of the cases showed evidence of BK polyomavirus infection in tumor or in surrounding mucosa by IHC. CISH performed in ten cases were also found to be negative. In comparison, one post-renal transplant urothelial carcinoma in our experience showed diffuse SV40 staining.

Conclusions: This study suggests that BK polyomavirus infection is not associated with urothelial malignancy in the immunocompetent setting unlike in the immunocompromised setting where it should always be investigated for.

Keywords: Chromogenic in situ hybridization; Immunocompetent; Polyomavirus; SV40 T-Antigen; Urothelial carcinoma.

Publication types

  • Review

MeSH terms

  • BK Virus / isolation & purification*
  • Carcinoma, Transitional Cell / diagnosis*
  • Carcinoma, Transitional Cell / pathology
  • Humans
  • Immunocompromised Host
  • Immunohistochemistry
  • In Situ Hybridization
  • India
  • Kidney Transplantation / adverse effects
  • Polyomavirus Infections / diagnosis*
  • Polyomavirus Infections / pathology
  • Polyomavirus Infections / virology
  • Tertiary Care Centers
  • Urinary Bladder Neoplasms / diagnosis*
  • Urinary Bladder Neoplasms / pathology
  • Urologic Neoplasms / diagnosis*
  • Urologic Neoplasms / pathology
  • Urothelium / pathology