尿液细胞学多瘤病毒感染的临床和细胞病理学检查分析  

Polyomavirus infection in urine cytology:a clinical and cytopathological analysis

作　　者：杨巧 陈佳 丁萍 聂尊珍 郭英 张兰兰 YANG Qiao;CHEN Jia;DING Ping;NIE Zun-zhen;GUO Ying;ZHANG Lan-lan(Department of Pathology,Daxing Hospital,Xi’an 710016,China)

机构地区：[1]西安大兴医院病理科,西安710016

出　　处：《诊断病理学杂志》2024年第12期1155-1159,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的 探讨尿液细胞学多瘤病毒(PyV)感染的临床、细胞病理学特征、诊断、鉴别诊断及临床意义。方法 收集西安大兴医院病理科2022年10月至2024年3月期间送检的尿液样本,共计2 128例,其中有PyV感染的病例15例共计18份样本,发病率约0.84%。回顾性分析15例PyV感染的临床资料、细胞学形态及免疫细胞化学染色结果。结果 15例多瘤病毒感染患者,年龄26~86岁(平均年龄57岁),男性13例,女性2例,7例有恶性肿瘤病史(包括前列腺癌2例,肾透明细胞癌2例,高级别尿路上皮癌、胃癌、口咽癌合并前列腺癌各1例),前列腺增生3例(1例伴肾透明细胞癌,1例伴泌尿道感染),肾移植术后2例,泌尿道感染3例,输尿管结石伴积水、腰痛待查各1例。镜下可见两种细胞成分,一种为核大形态规则、核膜光滑且染色质均质浓染的细胞,单核或双核,胞质丰富或稀少至无胞质;另一种细胞核更大,核膜略不规则,染色质丝网状、淡染,几乎无胞质。14/14例免疫细胞化学染色SV40阳性。结论 PyV感染的细胞,易误诊为非典型尿路上皮细胞或尿路上皮癌,对于肾移植术后患者关系到移植肾的存活时间,准确识别临床意义重大,形态结合SV40阳性可明确诊断。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

关 键 词：尿液细胞学 多瘤病毒 细胞病理 鉴别诊断 SV40 

分 类 号：R737[医药卫生—肿瘤]