Polyomavirus infection in urine cytology:a clinical and cytopathological analysis
Objective To explore the clinical and cytopathological features,diagnosis,differential diagnosis and clinical implication of polyoma virus infection in urine cytology.Methods A total of 2128 urine samples were collected from the Department of Pathology,Xi'an Daxing Hospital from October 2022 to March 2024,of which 18 samples were from 15 cases with polyomavirus infection,with an incidence rate of about 0.84％.The clinical data,cytology and immunocytochemistry staining were retrospectively analyzed in 15 cases of polyoma virus infection.Results Of the 15 patients with polyomavirus infection,13 were male and 2 were female,aged from 26 to 86 years(mean 57 years).Seven patients had a history of malignant tumors,including 2 cases of prostate cancer,2 cases of renal clear cell carcinoma,1 case of high-grade urothelial carcinoma,1 case of gastric cancer,and 1 case of oropharyngeal cancer combined with prostate cancer.3 cases had prostatic hyperplasia(1 case of renal clear cell carcinoma,1 case of gastric cancer,and 1 case of oropharyngeal cancer combined with prostate cancer).1 case was urinary tract infection,2 cases after kidney transplantation,3 cases with urinary tract infection,1 case had ureteral calculi with hydronephrosis,and 1 case had lumbago of unknown origin.Microscopically,there were two types of cellular components:one had large regular nuclei,smooth nuclear membranes,homogeneous and hyperchromatic chromatin,mononuclear or binuclear,and abundant or sparse to no cytoplasm;another had a larger nucleus with a slightly irregular nuclear membrane,reticular,lightly stained chromatin filaments,and almost no cytoplasm.Immunocytochemical staining for SV40 was positive in 14/14 cases.Conclusion Polyomavirus infected cells are easily misdiagnosed as atypical urothelial cells or urothelial carcinoma.For patients after kidney transplantation,it is related to the survival time of the transplanted kidney.Accurate identification is of great clinical significance,and the morphologic analysis combined with SV40 positive can confirm the diagnosis.
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