Cytomegalovirus colitis mimicking a colonic neoplasm or ischemic colitis 4 years after heart transplantation.
BACKGROUND
Cytomegalovirus (CMV) colitis is a polymorphous disease presenting in immunodepressed patients in a variety of clinical forms that can delay diagnosis and therapy. We report the case of a patient who presented with abdominal pain 4 years after heart transplantation; clinical and x-ray findings were suggestive of a neoplastic or ischemic stenosis, and histopathological examination likewise initially suggested an ischemic etiology.


METHODS
Tissue samples were fixed in 10% formaldehyde, embedded in paraffin, cut, and stained with hematoxylin/eosin and periodic acid-Schiff-Alcian Blue. Immunohistochemistry with monoclonal antibodies was performed using an indirect immunoperoxidase method.


RESULTS
CMV colitis was eventually diagnosed and resolved with surgery and specific anti-CMV therapy.


CONCLUSIONS
CMV colitis should be suspected in any heart transplant patient with signs or symptoms of abdominal pathology, even without classical signs or symptoms of CMV infection. If stenotic lesions are present, surgery may be required not only to remove the obstruction but also to rule out malignancy.
Crespo
M G
MG
Department of Pathology, Hospital Juan Canalejo, La Coruña, Spain.
Arnal
F M
FM
Gómez
M
M
Monserrat
L
L
Suarez
F
F
Rodríguez
J A
JA
Paniagua
M J
MJ
Cuesta
M
M
Juffé
A
A
Castro-Beiras
A
A
D002311:Cardiomyopathy, Dilated / Q000601:surgery; D003092:Colitis / Q000175:diagnosis* / Q000821:virology*; D003110:Colonic Neoplasms / Q000175:diagnosis*; D003586:Cytomegalovirus Infections; D003937:Diagnosis, Differential; D016027:Heart Transplantation / Q000009:adverse effects; D006801:Humans; D007511:Ischemia / Q000175:diagnosis* / Q000821:virology*; D008297:Male; D008875:Middle Aged