Human cytomegalovirus induced pseudotumor of upper gastrointestinal tract mucosa: Effects of long‐term chronic disease?

Abstract

Human cytomegalovirus-induced lesions resembling malignancies have been described in the gastrointestinal tract and include ulcerated or exophytic large masses. The aim of this study was to review the cases registered in the databases of two academic hospitals and formulate a hypothesis concerning the pathogenic mechanisms responsible for cytomegalovirus-induced pseudotumor development. All the diagnoses of human cytomegalovirus infections of the upper gastrointestinal tract recorded from 1991 to 2013 were reviewed. Cases of mucosal alterations misdiagnosed endoscopically as malignancies were selected. Large ulcers occurring in the stomach (three cases) and an irregular exophytic mass at the gastro-jejunal anastomosis were misdiagnosed endoscopically as malignancies (4 cases out of 53). Histologically, all lesions reflected hyperplastic mucosal changes with a prevalence of epithelial and stroma infected cells, without signs of cell atypia. The hypothesis presented is that the development of human cytomegalovirus-induced pseudotumors may be the morphological expression of chronic mucosa damage underlying long-term infection.

Cytomegalovirus induced pseudotumor of the colon in a renal transplanted patient

“…In our case, no such obstruction was seen however bleeding from rectum was noted, which is a rarity with these type of lesions. For gastrointestinal mass lesions in the transplant population, CMV induced pseudotumor should be included in the list of possible differential diagnosis (6). These tumors often responds to antiviral therapy.…”