A case of Cytomegalovirus (CMV) colitis associated with malignant lymphoma

Abstract

A 87-year-old man was admitted with right chest pain and an abnormal chest density on the chest X-ray examination or chest CT examination. A malignant tumor was diagnosed by CT guided needle biopsy. Radiotherapy was given for the lung tumor. Twelve days after radiotherapy, colonoscopy was performed and an ulcer in the rectum was recognized, performed. Because hemorrhage did not continue, he was treated with IVH with no sustenance by mouth. After about 2 weeks, colonoscopic findings showed extensive erosion occupying the entire lumen in the lower rectum. Microscopic findings of biopsy specimens obtained from the ulcers showed cytomegalic inclusion bodies, and we obtained positive stains by a immunohistochemical technique using a monoclonal antibody to CMV. The bloody discharge disappeared following treatment with ganciclovir for two weeks, but he died of respiratory failure due to his original illness after one month. The lung tumor was diagnosed as a malignant lymphoma and the rectal ulcer had disappeared on autopsy. This was a case of CMV enterocolitis associated with malignant lymphoma. CMV colitis should be included in the differential diagnosis of colitis of unknown etiology in immunocompromised hosts.