Abstract
Infection with cytomegalovirus (CMV) is a major feature of acquired immunodeficiency syndrome (AIDS). Gastrointestinal involvement is being seen more frequently. Our collective experience involves nine patients with stomach involvement. Seven patients were intravenous drug abusers or homosexuals with AIDS. One developed CMV gastritis as a complication of leukemia and one patient was a West African with lymphoma and human immunodeficiency virus (HIV) infection. All our patients had biopsy-proven CMV inclusion bodies. The radiographic appearances varied widely. The findings included markedly thickened edematous folds, erosive gastritis with aphthous ulceration, and superficial and deep ulceration. One patient had deep ulceration with fistula formation. Computed tomographic (CT) scans confirmed the greatly thickened gastric wall and coarsened folds in two patients. Associated gastrointestinal infections included candida and herpes, and, in addition, pneumocystis carinii pneumonia (PCP) was present in two patients. CMV gastritis may mimic several other conditions including erosive gastritis, peptic ulceration, lymphoma, and carcinoma. It should be strongly considered in immunosuppressed patients.
Similar content being viewed by others
References
Teixidor HS, Honig CL et al. Cytomegalovirus infection of the alimentary canal: radiologic finding with pathologic correlation.Radiology 1987;163:317–323
Balthazar E, Megibow A et al. Cytomegalovirus esophagitis and gastritis in AIDS.AJR 1985;144:1201–1204
Hochhauser L, Thomson G et al. Opportunistic gastritis and graft-versus-host disease.J Assoc Canad Radiol 1983;34:316–317
Ayulo M, Aisner SC et al. Cytomegalovirus associated gastritis in a compromised host.JAMA 1988;243:1364
Campbell DA, Percey RA et al. Cytomegalovirus associated gastric ulcer.Gastroenterology 1977;72:533–535
Marks MP, Lanza MV et al. Pediatric hypertrophic gastropathy.AJR 1986;147:1031–1034
Galloway PG. Widespread cytomegalovirus infection involving the gastrointestinal tract, biliary tree, and gallbladder in an immunocompromised patient.Gastroenterology 1984;87:1407
Knapp A, Horst D et al. Widespread cytomegalovirus gastroenterocolitis in a patient with acquired immunodeficiency syndrome.Gastroenterology 1983;85:1399–1402
Frager DH, Frager JD et al. Gastrointestinal complications of AIDS: radiologic features.Radiology 1986;158:597–603
Rosen P, Hayden S. Cytomegalovirus inclusion disease at autopsy of patients with cancer.Am J Clin Pathol 1971;55:749–756
Diethelin AG, Gore I et al. Gastrointestinal hemorrhage secondary to cytomegalovirus after renal transplantation.Am J Surg 1976;131:371–374
Balthazar EJ, Megibow AJ et al. Cytomegalvirus colitis: radiographic findings in 11 patients.Radiology 1985;155:585–589
Kram HB, Shoemaker WC. Intestinal perforation due to cytomegalovirus infection in patients with AIDS.Dis Colon Rectum 1990;33:1037–1040
Chachoria A, Dietrich D et al. 9-(1,3-dihydroxy-2-propoxymethel) quanine (Ganciclovir) in the treatment of cytomegalovirus gastrointestinal disease with the acquired immunodeficiency syndrome.Ann Intern Med 1987;107:133–137
Balthazar EJ, Megibow AJ et al. Cytomegalovirus esophagitis in AIDS: radiographic features in 16 patients.AJR 1987;149:919–923
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Farman, J., Lerner, M.E., Ng, C. et al. Cytomegalovirus gastritis: Protean radiologic features. Gastrointest Radiol 17, 202–206 (1992). https://doi.org/10.1007/BF01888548
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01888548