Urine cytology pitfalls due to Polyomaviruses

Annales de pathologie
Monique Courtade-SaïdiDominique d'Aure

Abstract

Specific cytopathologic changes represent an important tool for the identification of a viral infection. After primary infection, generally during childhood, BK and JC polyomaviruses often remain latent within the urinary tract and can reactivate along life. These reactivations are usually encountered in immunosuppressed patients. In renal transplanted recipients, BK virus may cause a polyomavirus nephropathy inducing sometimes graft loss. A good morphologic sign of reactivation is characterized by the shedding in urine of viral-infected cells called decoy cells. The latter are easily identified in urine from renal transplanted patients but in other circumstances, they may be misdiagnosed as high-grade urothelial carcinoma cells. Correct cytological identification of decoy cells, confirmation of the diagnosis by urine PCR analysis and use of immunocytochemistry with anti-SV40 antibody are of good value for differential diagnosis in most cases. However, polyomavirus reactivation and urothelial carcinoma cells may be observed in the same urine specimen. The possible involvement of BK or JC virus in the pathogenesis of human urogenital tumors has been suggested by some studies but is not yet conclusively resolved.

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Citations

Sep 13, 2013·Der Urologe. Ausg. A·M BöhmUNKNOWN Arbeitskreis Urinzytologie der DGU (Deutsche Gesellschaft für Urologie)
Mar 13, 2014·Urologic Oncology·Malte BöhmOliver W Hakenberg
Nov 23, 2016·Cytopathology : Official Journal of the British Society for Clinical Cytology·M Courtade-SaïdiL Lacoste-Collin

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