CC BY-NC-ND 4.0 · Endosc Int Open 2019; 07(04): E615-E620
DOI: 10.1055/a-0869-7828
Case report
Owner and Copyright © Georg Thieme Verlag KG 2019

Cytomegalovirus infection in a T-cell lymphoma patient presenting with multiple gastrointestinal ulcers: a case report

Jin Tao*
1   Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
,
Xian Yi Lin*
1   Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
,
Christ-Jonathan Tsia Hin Fong
1   Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
,
Zhuo Fu Wen
1   Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
,
Jian Ning Chen
2   Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
,
Qiong Liang
2   Department of Pathology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
,
Qu Lin
3   Department of Oncology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
,
Bin Wu
1   Department of Gastroenterology, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
› Author Affiliations
Further Information

Publication History

submitted 30 October 2018

accepted after revision 11 February 2019

Publication Date:
12 April 2019 (online)

Abstract

Background and study aims Gastrointestinal ulcers are responsible for a wide spectrum of diseases. Infection, drug-induced enteritis, malignancy, vasculitis and Inflammatory bowel disease are the most common causes; their clinical expression often varies according to the site and severity of intestinal involvement. We report on a 68-year-old male presenting with dyspepsia and melena and multiple gastrointestinal ulcers on endoscopy. We could not establish diagnosis of peripheral T-cell lymphoma not otherwise specified (PTCL-NOS) despite multiple biopsies taken on several endoscopic sessions, and cytomegalovirus (CMV) infection was documented by presence of inclusion bodies on pathology. The immunohistochemical study showed a mixture of B lymphocytes and predominantly T lymphocytes, negative for cluster of differentiation (CD)7. Southern blot gene rearrangement was positive for T-cell receptor beta. Our patient eventually expired from a massive gastrointestinal hemorrhage following four cycles of chemotherapy. We wish to emphasize that a CMV infection, as a comorbidity, can potentially mask and delay diagnosis of PTCL-NOS, especially in cases with aberrant immunophenotype presentation.

* Drs. Tao and Lin: These authors contributed equally.


 
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