ABSTRACT
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.
Subject(s)
Colitis/diagnosis , Colitis/virology , Colonic Neoplasms/diagnosis , Cytomegalovirus Infections , Ischemia/diagnosis , Ischemia/virology , Cardiomyopathy, Dilated/surgery , Diagnosis, Differential , Heart Transplantation/adverse effects , Humans , Male , Middle AgedABSTRACT
A case of inflammatory malignant fibrous histiocytoma of the mesocolon is reported. The lesion presented as a right lower quadrant abdominal mass, located at the mesocolon, with obstructive symptoms and accompanied by a severe infestation by Trichuris trichiura. It had a benign histologic appearance and was considered initially as an inflammatory and necrotic process with severe tissue eosinophilia secondary to the severe parasitosis. The tumor relapsed 13 months later at the anastomotic site and the patient died. Diagnostic, prognostic and therapeutic aspects of this rare tumor are discussed.
