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Case Reports
. 2012 May;6(2):266-72.
doi: 10.1159/000338842. Epub 2012 May 10.

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

Christopher B Tan  1 , Magdalene Vardaros, Apsara Prasad, Sadat Rashid, Keith Dahl, Duane Moise, Wondwoosen Gebre, Kaleem Rizvon, Paul Mustacchia
Affiliations
Case Reports

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

Christopher B Tan et al. Case Rep Gastroenterol. 2012 May.

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.

Keywords: Colon; Cytomegalovirus infection; Mass-like lesion.

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Figures

Fig. 1
Fig. 1
Colonoscopy showing an ulcerating mass at the ileocecal valve.
Fig. 2
Fig. 2
Computed axial tomography of the abdomen and pelvis showing a large cecal mass measuring 3.8 × 4.5 × 11 cm (arrow).
Fig. 3
Fig. 3
A Hematoxylin and eosin stain of the mass-like lesion (20× magnification). Note the normal-appearing colonic mucosa with preserved glandular tissues. B The mass-like lesion with active areas of inflammation and complete distortion of glandular tissues.
Fig. 4
Fig. 4
Hematoxylin and eosin stain of the same mass (60× magnification). Note the basophilic inclusion bodies ‘owl's eye’ appearance, characteristic of CMV infection (arrows).
Fig. 5
Fig. 5
Fig. 5. Follow-up colonoscopy. Note the complete resolution of the mass at the ileocecal junction.
See this image and copyright information in PMC

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