title: Skin carcinoma arising from donor cells in a kidney transplant recipient.
abstract: The incidence of skin cancer is increased in transplant recipients. UV radiation, papillomaviruses, and immunosuppression participate in the pathogenesis of these tumors. In addition, donor cells may leave the grafted organ, reach peripheral tissues and either induce immune phenomena or possibly take part in tissue remodeling. Herein, we investigated the possible involvement of donor cells in the development of skin tumors in kidney allograft recipients. We analyzed a series of 48 malignant and benign cutaneous tumors developing in 14 females who had been grafted with a male kidney. The number of male cells was measured on microdissected material by quantitative PCR for Y chromosome. In the samples with high levels of male cells, fluorescent in situ hybridization (FISH) with X and Y probes and/or immuno-FISH with anticytokeratin antibodies were carried out. Male cells were detected in 5/15 squamous cell carcinomas and Bowen disease (range 4-180 copies), 3/5 basal cell carcinomas (91-645), 6/11 actinic keratosis (7-102), 2/4 keratoacanthoma (22-41), and 2/5 benign cutaneous lesions (14-55). In a basal cell carcinoma specimen with a high number of male cells, FISH showed that most cells within the tumoral buds were XY. In this lesion, immuno-FISH showed the presence of XY cytokeratin-positive cells indicating that the tumor nests contained male keratinocytes. In contrast, in other female transplants, male cells present in the tumors were not epithelial. In conclusion, stem cells originating from a grafted kidney may migrate to the skin, differentiate, or fuse as keratinocytes that could, rarely, undergo cancer transformation.
authors.affiliation: Unité de Dermatologie, Hôpital Tenon, Paris, France.
authors.forename: Sélim
authors.initials: S
authors.lastname: Aractingi
authors.forename: Jean
authors.initials: J
authors.lastname: Kanitakis
authors.forename: Sylvie
authors.initials: S
authors.lastname: Euvrard
authors.forename: Caroline
authors.initials: C
authors.lastname: Le Danff
authors.forename: Isabelle
authors.initials: I
authors.lastname: Peguillet
authors.forename: Kiarash
authors.initials: K
authors.lastname: Khosrotehrani
authors.forename: Olivier
authors.initials: O
authors.lastname: Lantz
authors.forename: Edgardo D
authors.initials: ED
authors.lastname: Carosella
mesh_terms: D001913:Bowen's Disease / Q000209:etiology; D002280:Basal Cell Carcinoma / Q000209:etiology; D002294:Carcinoma, Squamous Cell / Q000209:etiology; D002454:Cell Differentiation; D002459:Cell Fusion; D041321:Chromosomes, Human, X / Q000235:genetics; D041322:Chromosomes, Human, Y / Q000235:genetics; D005260:Female; D006801:Humans; D007124:Immunoenzyme Techniques; D017404:In Situ Hybridization, Fluorescence; D007621:Karyotyping; D015603:Keratinocytes / Q000166:cytology / Q000378:metabolism; D007633:Keratins / Q000378:metabolism; D007636:Keratoacanthoma / Q000209:etiology; D007642:Keratosis / Q000209:etiology; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012871:Skin Diseases / Q000209:etiology*; D012878:Skin Neoplasms / Q000209:etiology*; D013234:Stem Cells / Q000378:metabolism / Q000473:pathology*; D014019:Tissue Donors; D014184:Transplantation, Homologous
chemical_list: D007633:Keratins