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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
Authors:Sara Querido,Isabel Fernandes,Andr   Weigert,Sandra Casimiro,Catarina Albuquerque,S  ncia Ramos,Teresa Adrag  o,Ivan Luz,Paulo Paix  o,Maria Chasqueira,Madalena Santos,Domingos Machado
Affiliation:Sara Querido,Isabel Fernandes,André Weigert,Sandra Casimiro,Catarina Albuquerque,Sância Ramos,Teresa Adragão,Ivan Luz,Paulo Paixão,Maria Chasqueira,Madalena Santos,Domingos Machado
Abstract: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.
Keywords:clinical research  practice  kidney transplantation  nephrology  urology  pathology  histopathology  cancer  malignancy  neoplasia: metastatic disease  cancer  malignancy  neoplasia: risk factors  infection and infectious agents –   viral  infection and infectious agents –   viral: BK  JC  polyoma  kidney disease: infectious
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