Cytomegalovirus colitis masquerading as rectal malignancy in an immunocompetent patient

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.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anal Canal / pathology
  • Antigens, Viral / analysis
  • Antiviral Agents / therapeutic use
  • Colitis / diagnosis*
  • Colitis / drug therapy
  • Colitis / pathology*
  • Colitis / virology
  • Cytomegalovirus / isolation & purification*
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / pathology*
  • Cytomegalovirus Infections / virology
  • Diagnosis, Differential
  • Female
  • Histocytochemistry
  • Humans
  • Immunohistochemistry
  • Microscopy
  • Rectal Neoplasms / diagnosis*
  • Rectal Neoplasms / pathology*
  • Rectum / pathology

Substances

  • Antigens, Viral
  • Antiviral Agents