在一名免疫功能正常的患者中,伪装成直肠恶性肿瘤的巨细胞病毒性结肠炎。

Cytomegalovirus colitis masquerading as rectal malignancy in an immunocompetent patient.

作者信息

Jacob Sunitha, Zayyani Najah R

机构信息

Department of Pathology, Bahrain Specialist Hospital, Juffair, Manama, Bahrain.

出版信息

Indian J Pathol Microbiol. 2015 Jan-Mar;58(1):80-2. doi: 10.4103/0377-4929.151195.

Abstract

Gastrointestinal tract (GIT) involvement by cytomegalovirus (CMV) infection is well-recognized in immunosuppressed patients but is uncommon in immunocompetent hosts. The colon and esophagus are the most frequently affected sites with punched out ulcers being the characteristic mucosal lesion. CMV-induced pseudotumor is an exceptionally rare presentation, especially in immunocompetent hosts. A 76-year-old immunocompetent female presented with abdominal pain and constipation. Colonoscopy revealed an ulcerated polypoidal tumor-like mass in the anorectal region. Biopsy of the lesion showed large basophilic intranuclear inclusions which were positive for CMV on immunohistochemical staining. The patient responded to 2 weeks of antiviral therapy with complete resolution of the mass. Although rare, pseudotumors associated with CMV infection should be considered in the differential diagnosis of tumorous lesions of the GIT.

摘要

巨细胞病毒(CMV)感染累及胃肠道(GIT)在免疫抑制患者中已得到充分认识,但在免疫功能正常的宿主中并不常见。结肠和食管是最常受累的部位,特征性的黏膜病变为凿孔状溃疡。CMV诱导的假瘤是一种极其罕见的表现,尤其是在免疫功能正常的宿主中。一名76岁免疫功能正常的女性因腹痛和便秘就诊。结肠镜检查显示在肛门直肠区域有一个溃疡样息肉状肿瘤样肿块。病变活检显示有大的嗜碱性核内包涵体,免疫组化染色CMV呈阳性。患者接受了2周的抗病毒治疗,肿块完全消退。尽管罕见,但在GIT肿瘤性病变的鉴别诊断中应考虑与CMV感染相关的假瘤。

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