Cytomegalovirus Colitis Mimicking Rectal Carcinoma in a Young Immunocompetent Patient

Shah, Rushikesh; Vaidya, Gaurang; Kalakonda, Aditya; Manocha, Divey; Rawlins, Sekou

doi:10.14309/crj.2015.42

Cited by 38 publications

(5 citation statements)

References 6 publications

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“…The differential diagnosis of rectal masses in patients with HIV is broad and includes infectious causes, such as lymphogranuloma venereum, syphilis, CMV, and HHV-8 [1,2,3]. Non-infectious pathologies, such as lymphoma or squamous cell carcinoma, are also important entities to consider in this population [4,5].…”

Section: Discussionmentioning

confidence: 99%

Herpes Simplex Virus Proctitis Masquerading as Rectal Cancer

2019

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Herpes simplex virus (HSV) is the leading cause of proctitis in HIV-infected individuals. However, no cases of rectal masses secondary to HSV infection have been reported to date. Herein, we present the case of a 45-year-old man with HIV infection who developed rectal pain and bleeding, along with dysuria and voiding difficulty. Colonoscopy revealed proctitis and a rectal mass with features concerning for rectal cancer. Histologic sections of the rectal mass biopsy demonstrated colorectal mucosa with viral cytopathic changes, ulceration, granulation tissue, marked inflammatory infiltrate, and fibrinopurulent exudate. Immunohistochemistry for herpes simplex virus-1 was positive in epithelial cells demonstrating a viral cytopathic effect. The patient was treated with valacyclovir for 3 weeks, which led to complete resolution of his symptoms. Follow-up sigmoidoscopy at 6 months did not show any masses. Our case illustrates the importance of considering HSV in the differential diagnosis of rectal masses. We advocate the routine use of viral immunohistochemistry for the evaluation of rectal tumors, especially in patients with clinical manifestations and endoscopic findings consistent with proctitis.

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Section: Discussionmentioning

confidence: 99%

Herpes Simplex Virus Proctitis Masquerading as Rectal Cancer

2019

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“…Historically it was reported that patients with CMV proctitis can present with rectal ulcers [9] . Upon literature review several case reports make mention of CMV colitis mimicking colorectal malignancy [10] , [11] , [12] .…”

Section: Discussionmentioning

confidence: 99%

Systemic cytomegalovirus masquerading as a colorectal mass in a patient with undiagnosed HIV/AIDS

Madala

Silva

Cardona

et al. 2022

IDCases

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“…Esophageal ulcers are more common distally and usually have discrete borders, but they can be confluent and span up to 10 cm [52]. CMV rarely elicits an exuberant inflammatory reaction that simulates malignancy [53]. CMV infection is associated with variable inflammatory changes depending on the immune status of the patient.…”

Section: Hiv and Aidsmentioning

confidence: 99%

Inflammatory and infectious manifestations of immunodeficiency in the gastrointestinal tract

Panarelli

Yantiss

2018

Modern Pathology

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Immune compromise may result from genetic abnormalities, HIV/AIDS, or consequences of therapy for neoplastic and autoimmune diseases. Many immunocompromised patients develop severe gastrointestinal symptoms, particularly diarrhea, accompanied by non-specific or mild endoscopic abnormalities; mucosal biopsy with pathologic interpretation has a major role in the diagnosis and management of these patients. Immunocompromised individuals are at risk for all the diseases that affect those with a healthy immune system, but they are also prone to other illnesses that rarely affect immunocompetent patients. This review discusses the gastrointestinal manifestations of primary and acquired immunodeficiency, chemotherapy-related injury, and infections that show a predilection for immunocompromised patients. Key histologic features and relevant differential diagnoses are emphasized.

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Cytomegalovirus Colitis Mimicking Rectal Carcinoma in a Young Immunocompetent Patient

Cited by 38 publications

References 6 publications

Herpes Simplex Virus Proctitis Masquerading as Rectal Cancer

Herpes Simplex Virus Proctitis Masquerading as Rectal Cancer

Systemic cytomegalovirus masquerading as a colorectal mass in a patient with undiagnosed HIV/AIDS

Inflammatory and infectious manifestations of immunodeficiency in the gastrointestinal tract

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