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Clinicopathologic and Molecular Characteristics of Merkel Cell Polyomavirus Positive T-Cell Lymphoproliferative Disorders.

Clinicopathologic and Molecular Characteristics of Merkel Cell Polyomavirus Positive T-Cell Lymphoproliferative Disorders. The American journal of surgical pathology Bulterys, P., Zhou, C. W., Gong, S., Gars, E., Zhang, J., Younes, S., Stone, A., Hirt, C., Marks, L., Su, C., Stehr, H., Lawrence, L., Tan, B., Weinberg, K., Tan, J., Starostik, P., Khodadoust, M., Naor, S., Gratzinger, D., Natkunam, Y., Kurzer, J., Fernandez-Pol, S. 2026; 50 (5): 481-500

Abstract

Previous work described 3 cases of CD4+ T-cell lymphomas harboring Merkel cell polyomavirus (MCPyV), as demonstrated by in situ hybridization (ISH), next generation sequencing, and polymerase chain reaction. Two of these cases were cutaneous T-cell lymphomas compatible with mycosis fungoides in postcardiac transplant patients, while the third was a peripheral T-cell lymphoma, not otherwise specified (PTCL-NOS), in a patient without known immunosuppression. In this study, we assess an expanded cohort of T-cell neoplasms from 4 institutions for expression of MCPyV by ISH. This cohort includes 9 T-cell lymphomas occurring in the post solid organ transplant setting, of which 5 (60%) were positive for MCPyV by ISH. Four of these cases were classified as PTCL-NOS and the remaining case as nodal T follicular helper cell lymphoma, angioimmunoblastic type. In addition, we performed MCPyV ISH on a variety of neoplastic and non-neoplastic lymphoid tissues from both transplant and nontransplant patients. No evidence of MCPyV infection was found in lymphoid tissues in the absence of T-cell lymphoma, suggesting that the presence of MCPyV is specific to this rare subset of T cell lymphomas. Furthermore, all MCPyV-positive T-cell lymphomas (8 of 8) were CD4+ and the large majority were observed in the post-transplant setting (7 of 8). Multiplex single-molecule fluorescence ISH confirmed the presence of MCPyV in CD4+ T-cells. These findings support the hypothesis that MCPyV infection is specifically associated with rare CD4+ T-cell lymphomas, particularly in transplant recipients.

View details for DOI 10.1097/PAS.0000000000002521

View details for PubMedID 41980878