PMC7773455_01
(a) The nephrectomy specimen demonstrated infiltrative nests of tumor cells with prominent nucleoli, moderate pleomorphism, and scattered mitoses (H&E). (b) Nuclear expression for p63 in the tumor cells supports the diagnosis of urothelial carcinoma. (c) SV40/BKV stain showing positive staining in the tumor cells. (d) PAX8 is negative in tumor cells, excluding renal cell carcinoma.
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fig1
IgA nephropathy recurrence. Immunohistochemistry (IHC) stains were negative for C4d and PAX8 and positive for p63, GATA3, CK20, p16, and SV40/BKV (see Figure 1), consistent with UTUC with BK viral protein expression.
PET/CT scans showing improvement in metastatic disease with reduction in hepatic mass and decreased retroperitoneal, pelvic, and iliac lymphadenopathy after 4 cycles of pembrolizumab.
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fig2
She received 28 cycles of pembrolizumab 200 mg IV every three weeks over about 19 months, achieving complete radiological response, with 15-month progression-free survival to date off therapy (see Figure 2).