Open AccessDecoy cells in the urine cytology of a renal transplant recipient: An immunohistochemical study
Author(s) -
Kamala Pillai,
K Jayasree,
Ramdas Pisharody,
Elizabeth Abraham
Publication year - 2010
Publication title -
indian journal of pathology and microbiology/indian journal of pathology and microbiology
Language(s) - English
Resource type - Journals
eISSN - 0974-5130
pISSN - 0377-4929
DOI - 10.4103/0377-4929.64345
Subject(s) - pathology , urine cytology , transplantation , urine , kidney , cytology , immunohistochemistry , immunoperoxidase , antigen , biology , medicine , cancer , bladder cancer , immunology , antibody , monoclonal antibody
Human polyoma virus causes renal dysfunction and graft loss as a result of tubulo-interstial nephritis in renal transplant recipients after reactivation of latent virus in renal epithelium. The infected cells in the urinary sediments are characterized by large homogenous inclusions, which may cause diagnostic error in urine cytology. The epithelial cells with polyoma viral inclusions in urine cytology specimens are termed Decoy cells to caution pathologists not to misdiagnose these cells as cancer cells. We present a case of polyoma viral changes detected the first time in our laboratory in the urine of a 46year old male who underwent renal transplantation six months back and followed by immunotherapy. Urine cytological examination showed decoy cells and subsequently revealed on histopathology. Immunoperoxidase staining for SV-40 LT antigen (LT ag), expression of proliferating cell nuclear antigen (PCNA), p53 and Rb genes were also studied in the tissue sections for further observation. The expression of SV40 LT ag was negative, while PCNA showed strong positivity; p53 and Rb were expressed moderately in the nuclei of cells in the tubules. The report of a case of decoy cells in the urine of a patient with renal transplantation focuses the importance of cytologic analysis of urine as a diagnostic tool for screening renal transplant recipients at risk of polyoma viral infection.