Polyoma virus-associated cellular changes in the urine and bladder biopsy samples: a cytohistologic correlation

摘要: Polyoma (BK) virus-type cellular changes are occasionally reported in urine specimens, yet rarely detected histologic sections of bladder biopsies. A total 762 predominantly voided specimens with a cytologic diagnosis polyoma change were retrieved from the cytopathology files Johns Hopkins Hospital over 15-year period (1988-2003). Biopsies available for 33 cases (29 patients) following or preceding urinary cytology (mean interval, 210 days). The biopsies originated primarily (n=31) one biopsy each renal pelvis and urethra. Representative paraffin blocks chosen case immunoperoxidase staining SV40 large T antigen. There 22 males 7 females an age range 34 to 79 years (mean, 64.7 years). diagnoses tissue were: benign urothelium (n=9), urothelial carcinoma (n=21) 1 dysplasia, small cell carcinoma, chronic lymphocytic leukemia involving lamina propria bladder. Only 3 on hematoxylin-stained showed morphologic virus, which lacked sufficient perform immunohistochemistry antigen (LTag). Immunohistochemical LTag was positive cases. 2 strong/diffuse moderate/focal both representing invasive high-grade (where no inclusions seen hematoxylin eosin-stained sections) demonstrating immunostaining p53. One these organ transplant recipient other patient known immunosuppression. Our data lead conclusions: 1) appears be more sensitive than histology detecting cells virus; 2) cytohistologic discordance might due to: a) virus infected shed collected urine; b) may focal not sampled directed biopsies; c) originate sites genitourinary tract bladder; d) lack "gold standard" confirm e) time between current retrospective study. 3) Because some cytologically associated malignant biopsies, careful evaluation is required avoid false-negative samples. This investigation further examined immunohistochemical pattern p53 noninvasive low-grade papillary using microarray constructed randomly selected patients. Weak present occasional neoplastic only four samples tumor (0.63%; 316 spots), illustrates patchy presence virion containing cells. two spots also confined rare nuclei.