Crespo M G, Arnal F M, Gómez M, Monserrat L, Suarez F, Rodríguez J A, Paniagua M J, Cuesta M, Juffé A, Castro-Beiras A
Department of Pathology, Hospital Juan Canalejo, La Coruña, Spain.
Transplantation. 1998 Dec 15;66(11):1562-5. doi: 10.1097/00007890-199812150-00023.
Cytomegalovirus (CMV) colitis is a polymorphous disease presenting in immunodepressed patients in a variety of clinical forms that can delay diagnosis and therapy. We report the case of a patient who presented with abdominal pain 4 years after heart transplantation; clinical and x-ray findings were suggestive of a neoplastic or ischemic stenosis, and histopathological examination likewise initially suggested an ischemic etiology.
Tissue samples were fixed in 10% formaldehyde, embedded in paraffin, cut, and stained with hematoxylin/eosin and periodic acid-Schiff-Alcian Blue. Immunohistochemistry with monoclonal antibodies was performed using an indirect immunoperoxidase method.
CMV colitis was eventually diagnosed and resolved with surgery and specific anti-CMV therapy.
CMV colitis should be suspected in any heart transplant patient with signs or symptoms of abdominal pathology, even without classical signs or symptoms of CMV infection. If stenotic lesions are present, surgery may be required not only to remove the obstruction but also to rule out malignancy.
巨细胞病毒（CMV）结肠炎是一种多形性疾病，在免疫抑制患者中以多种临床形式出现，可能会延迟诊断和治疗。我们报告了一例心脏移植术后4年出现腹痛的患者；临床和X线检查结果提示为肿瘤性或缺血性狭窄，组织病理学检查最初同样提示为缺血性病因。
将组织样本固定于10%甲醛中，石蜡包埋，切片，并用苏木精/伊红和过碘酸-希夫-阿尔辛蓝染色。使用间接免疫过氧化物酶法进行单克隆抗体免疫组织化学检测。
最终诊断为CMV结肠炎，通过手术和特异性抗CMV治疗得以解决。
任何有腹部病变体征或症状的心脏移植患者，即使没有CMV感染的典型体征或症状，都应怀疑CMV结肠炎。如果存在狭窄性病变，可能不仅需要手术解除梗阻，还需要排除恶性肿瘤。
