Limits...
Cytomegalovirus infection of the colon presenting as a mass-like lesion.

Tan CB, Vardaros M, Prasad A, Rashid S, Dahl K, Moise D, Gebre W, Rizvon K, Mustacchia P - Case Rep Gastroenterol (2012)

Bottom Line: CMV rarely presents as an intraluminal inflammatory mass in the colon.Here we report the case of a CMV infection presenting as a mass-like lesion in an AIDS patient.Endoscopic procedures are encouraged early in the course of CMV infection in immunocompromised patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Nassau University Medical Center, East Meadow, N.Y., USA.

ABSTRACT
Cytomegalovirus (CMV) is responsible for the most common opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS). The colon is a common site for these infections in patients positive for human immunodeficiency virus. CMV rarely presents as an intraluminal inflammatory mass in the colon. Here we report the case of a CMV infection presenting as a mass-like lesion in an AIDS patient. The clinical diagnosis of CMV infection is largely based on the characteristic endoscopic appearance. Endoscopic procedures are encouraged early in the course of CMV infection in immunocompromised patients. CMV pseudotumors along with malignancy should be part of the endoscopic evaluation in patients with AIDS.

No MeSH data available.


Related in: MedlinePlus

Colonoscopy showing an ulcerating mass at the ileocecal valve.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC3369417&req=5

Figure 1: Colonoscopy showing an ulcerating mass at the ileocecal valve.

Mentions: The patient responded to fluid resuscitation and was monitored in the medical intensive care unit. He was scheduled for esophagogastroduodenoscopy (EGD) and colonoscopy to investigate the source of bleeding. Two units of packed red blood cells were transfused prior to the procedure. EGD showed healing esophageal erosions, gastric erosions and erythematous antrum. Colonoscopy revealed an ulcerating mass at the ileocecal valve (fig. 1). Multiple biopsies were taken and sent for histopathologic examination. Due to a high suspicion of a possible neoplastic process, a computed axial tomography scan of the abdomen and pelvis with contrast was done. It revealed a 3.8 × 4.5 × 11 cm mass involving the cecum and ascending colon, with marked eccentric wall thickening and peripheral enhancement (fig. 2). At least five discrete hypodense liver lesions suspicious for metastases were also noted. Surgical pathologic results of the mass came back as fragments of granulation tissue with inflammatory changes highly suggestive of CMV infection (fig. 3). The characteristic basophilic inclusion bodies (‘owl's eye’) were demonstrated within the granulation tissue on histologic examination (fig. 4). Special staining for acid-fast bacilli and fungi was negative.


Cytomegalovirus infection of the colon presenting as a mass-like lesion.

Tan CB, Vardaros M, Prasad A, Rashid S, Dahl K, Moise D, Gebre W, Rizvon K, Mustacchia P - Case Rep Gastroenterol (2012)

Colonoscopy showing an ulcerating mass at the ileocecal valve.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC3369417&req=5

Figure 1: Colonoscopy showing an ulcerating mass at the ileocecal valve.
Mentions: The patient responded to fluid resuscitation and was monitored in the medical intensive care unit. He was scheduled for esophagogastroduodenoscopy (EGD) and colonoscopy to investigate the source of bleeding. Two units of packed red blood cells were transfused prior to the procedure. EGD showed healing esophageal erosions, gastric erosions and erythematous antrum. Colonoscopy revealed an ulcerating mass at the ileocecal valve (fig. 1). Multiple biopsies were taken and sent for histopathologic examination. Due to a high suspicion of a possible neoplastic process, a computed axial tomography scan of the abdomen and pelvis with contrast was done. It revealed a 3.8 × 4.5 × 11 cm mass involving the cecum and ascending colon, with marked eccentric wall thickening and peripheral enhancement (fig. 2). At least five discrete hypodense liver lesions suspicious for metastases were also noted. Surgical pathologic results of the mass came back as fragments of granulation tissue with inflammatory changes highly suggestive of CMV infection (fig. 3). The characteristic basophilic inclusion bodies (‘owl's eye’) were demonstrated within the granulation tissue on histologic examination (fig. 4). Special staining for acid-fast bacilli and fungi was negative.

Bottom Line: CMV rarely presents as an intraluminal inflammatory mass in the colon.Here we report the case of a CMV infection presenting as a mass-like lesion in an AIDS patient.Endoscopic procedures are encouraged early in the course of CMV infection in immunocompromised patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Medicine, Nassau University Medical Center, East Meadow, N.Y., USA.

ABSTRACT
Cytomegalovirus (CMV) is responsible for the most common opportunistic infections in patients with acquired immunodeficiency syndrome (AIDS). The colon is a common site for these infections in patients positive for human immunodeficiency virus. CMV rarely presents as an intraluminal inflammatory mass in the colon. Here we report the case of a CMV infection presenting as a mass-like lesion in an AIDS patient. The clinical diagnosis of CMV infection is largely based on the characteristic endoscopic appearance. Endoscopic procedures are encouraged early in the course of CMV infection in immunocompromised patients. CMV pseudotumors along with malignancy should be part of the endoscopic evaluation in patients with AIDS.

No MeSH data available.


Related in: MedlinePlus