title: Merkel cell carcinoma arising in inguinal lymph node in a patient with von Willebrand disease after multiple blood transfusions.
abstract: Merkel cell carcinoma (MCC) is an uncommon neuroendocrine tumour of the skin; rare cases have been reported within the lymph nodes without a primary site. The detection of Merkel cell polyomavirus (MCPyV) DNA, integrated within the genome of MCC, suggests its role for the onset of this tumour. We report a case of MCC in an inguinal lymph node of a patient with Von Willebrand disease (VWD), who underwent multiple blood transfusions following haemorrhoidectomy. The diagnosis was performed on the bases of morphology and immunohistochemistry; genomic sequences of LT and VP1 regions of MCPyV were amplified from MCC using a quantitative polymerase chain reaction (qPCR) assay. High levels of MCPyV antibodies were detected in the patient's serum by ELISA method. We discuss the role of MCPyV in the development of this tumour, the use of viral DNA detection for confirming the diagnosis of MCC in unusual sites and the possibility of MCPyV transmission from blood donors.
authors.affiliation: Department of Health Sciences and Translational Medicine, School of Medicine, University of Eastern Piedmont, and "Maggiore della Carità" Hospital, 28100 Novara, Italy. Electronic address: renzo.boldorini@med.unipmn.it.
authors.forename: Renzo
authors.initials: R
authors.lastname: Boldorini
authors.affiliation: Department of Health Sciences and Translational Medicine, School of Medicine, University of Eastern Piedmont, and "Maggiore della Carità" Hospital, 28100 Novara, Italy.
authors.forename: Sara
authors.initials: S
authors.lastname: Allegrini
authors.affiliation: Department of Morphology, Surgery and Experimental Medicine, School of Medicine, University of Ferrara, 44100 Ferrara, Italy.
authors.forename: Mauro
authors.initials: M
authors.lastname: Tognon
authors.affiliation: Department of Health Sciences and Translational Medicine, School of Medicine, University of Eastern Piedmont, and "Maggiore della Carità" Hospital, 28100 Novara, Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Miglio
authors.affiliation: Department of Health Sciences and Translational Medicine, School of Medicine, University of Eastern Piedmont, and "Maggiore della Carità" Hospital, 28100 Novara, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Rossi
authors.affiliation: German Cancer Research Centre, 69120 Heidelberg, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Pawlita
authors.affiliation: Department of Pediatrics, John Hopkins University, 21205 Baltimore, MD, USA.
authors.forename: Raphael
authors.initials: R
authors.lastname: Viscidi
mesh_terms: D000914:Antibodies, Viral / Q000097:blood; D001803:Blood Transfusion; D015266:Carcinoma, Merkel Cell / Q000175:diagnosis* / Q000473:pathology*; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000473:pathology*; D008297:Male; D059965:Merkel cell polyomavirus / Q000235:genetics; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction; D014842:von Willebrand Diseases / Q000150:complications* / Q000628:therapy*
chemical_list: D000914:Antibodies, Viral
keywords: Lymph node; Merkel cell carcinoma (MCC); Merkel cell polyomavirus (MCPyV); Von Willebrand disease