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Case Reports
. 1998 Jul;13(2):143-6.
doi: 10.3904/kjim.1998.13.2.143.

A case of CMV disease of the jejunum in a patient with non-Hodgkin's lymphoma

K J Han  1 , I S Jung, C K Kim, S K Park, D W Kim, S H Baick, J H Won, D S Hong, S D Hwang, C Moon, H S Park
Affiliations
Case Reports

A case of CMV disease of the jejunum in a patient with non-Hodgkin's lymphoma

K J Han et al. Korean J Intern Med. 1998 Jul.

Abstract

CMV infection may occur anywhere in the gastrointestinal tract. Among the small intestine, ileum is the most common site of CMV disease and infection of jejunum is a rare one in patients with CMV gastroenteritis. Although rare, the reason why the recognition of this diagnosis is important is that it cause the lethal hemorrhage and perforation of gastrointestinal tract when its diagnosis and treatment was delayed. Rapid diagnosis are able to using the immunohistochemical stain in shell vial culture of infected specimen or peripheral neutrophils preparation in viremic patients within 8 to 36 hours. The treatment of choice is antiviral agent or surgical resection. We experienced a case of CMV disease of jejunum in patient with non-Hodgkin's lymphoma who showed severe ulceration in jejunum and massive intestinal hemorrhage, and he survived after successful treatment with segmental resection of jejunum and intravenous ganciclovir.

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Figures

Fig. 1.
Fig. 1.
Surgical specimen of jejunum a: Several discrete ulcers, irregular in shape and size, are seen. Intervening mucosa showed irregularity, nodularity, and pseudopolyp appearance, b: The ulcer base consist of necrotic exudate.
Fig. 2.
Fig. 2.
a: Cytomegalovirus inclusions in endothelial cells of jejunum. There are many enlarged cells with purple cytoplasmic inclusions in submucosa and muscle layer of ulceration area(H&E stain ×400). b: CMV inclusion body in glandular cells of endoscopic biopsy specimen of stomach(H&E stain ×400).
Fig. 3.
Fig. 3.
a: In paraffin-embedded surgical specimen of jejunum, immunohistochemical stain using monoclonal antibody for CMV PP65 antigen showed strong positive reaction in epithelial layer(×400). b: Also, positive stains were noted in cytospin preparation and peripheral neutrophils(×400).
See this image and copyright information in PMC

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