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Cytomegalovirus gastritis: protean radiologic features
1Department of Radiology, Columbia-Presbyterian Medical Center, New York, New York 10032-3284.
Gastrointestinal Radiology
|January 1, 1992
Summary
Cytomegalovirus (CMV) infection frequently affects the gastrointestinal tract in patients with acquired immunodeficiency syndrome (AIDS). This study highlights CMV gastritis, emphasizing its varied radiographic presentations and potential to mimic other serious gastric conditions in immunocompromised individuals.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Oncology
Background:
- Cytomegalovirus (CMV) infection is a significant opportunistic infection in individuals with acquired immunodeficiency syndrome (AIDS).
- Gastrointestinal involvement by CMV is increasingly recognized, particularly in the stomach.
- This study reviews nine cases of CMV gastritis in immunocompromised patients.
Observation:
- Patients included individuals with AIDS, leukemia, lymphoma, and human immunodeficiency virus (HIV) infection.
- All patients presented with biopsy-proven CMV inclusion bodies in the stomach.
- Radiographic findings were diverse, including thickened gastric folds, erosive gastritis, and ulcerations.
Findings:
- Radiological appearances varied, encompassing edematous folds, aphthous ulceration, and deep ulcerations, with one case of fistula formation.
- Computed tomography (CT) scans revealed thickened gastric walls and coarsened folds.
- Concurrent infections such as Candida, herpes, and Pneumocystis carinii pneumonia (PCP) were noted in some patients.
Implications:
- CMV gastritis can present with a wide range of symptoms and imaging findings.
- It may be mistaken for other gastric pathologies like peptic ulcer disease, lymphoma, or gastric cancer.
- Strong consideration of CMV gastritis is crucial for timely diagnosis and management in immunosuppressed patients.