Acute pancreatitis with cytomegalovirus infection

An autopsy case of necrotizing pancreatitis with cytomegalovirus (CMV) infection is reported. A 50-year-old housewife was admitted because of malignant choroid plexus papilloma of the fourth ventricle. Serum amylase transiently elevated during irradiation and chemotherapy for brain tumor, one month before death. The patient died of a respiratory failure. At autopsy focal necrosis was mainly observed in the peripancreatic adipose tissue and occasionally in the parenchyma of the tail. Fibrosis and inflammatory infiltration was found around the necrosis and interstitium. Cytomegalic cells with intranuclear inclusions and/or cytoplasmic granules were observed frequently in the acini near the necrosis. Immunohistological study revealed CMV antigen in the cytomegalic cells. Herpesvirus-type particles were observed in the nucleus and cytoplasm of the cytomegalic cells. CMV infection of the acini are thought to cause necrotic changes in the pancreas.