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Bladder
Cystitis
Author: Nat Pernick, M.D. (see Authors page)
Revised: 17 December 2009, last major update - December 2009, UPDATE IN PROGRESS
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Definition
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● Cystitis due to infection with human polyoma BK virus
Terminology
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● BK is a type of polyoma virus - others are JC virus and simian virus 40; each encodes a highly homologous form of a large T antigen, a transcriptional and replicational regulatory protein
Epidemiology
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● Associated with hemorrhagic cystitis in blood and marrow transplant recipients (Bone Marrow Transplant 2008;41:11)
● Also associated with ureteral stenosis and interstitial nephritis in renal transplant patients (Hum Pathol 2006;37:684)
Sites
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Etiology
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● Hemorrhagic cystitis may be due to BK or JC viruses (J Med Virol 2010;82:138)
Clinical features
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● Real time PCR can detect BK virus DNA in urine, although high BKV viruria is not necessarily associated with kidney or bladder damage (New Microbiol 2007;30:275)
● Polyoma virus infection may be a risk factor for bladder carcinoma in immunocompetent patients (Diagn Cytopathol 2006;34:201)
Prognostic factors
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Case reports
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Treatment
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● Possibly intravenous cidofovir (Clin Infect Dis 2009;48:e86) or hyperbaric oxygen (Leuk Res 2009;33:556)
Clinical images
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Gross description (Macroscopy)
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Gross images
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Micro description (Histopathology)
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Micro images
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Cytology description
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● Decoy cells are epithelial cells containing intranuclear viral inclusions in urine (Adv Exp Med Biol 2006;577:201)
● Urine cytology appears to be more sensitive than histology in detecting cells with polyoma virus (Am J Surg Pathol 2006;30:345)
● Note: pancreatic enzymes can degrade decoy cells and granulocytes (Clin Transplant 2008;22:833)
Cytology images
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Decoy cells with enlarged nuclei and homogenized chromatin due to viral inclusions
Images without thumbnails: renal tubular cells #1; #2; #3
SV40+
Positive stains
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● SV-40
Negative stains
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Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● (link to topic)
Additional references
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End of Bladder > Cystitis > BK virus
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