PMC5884229_01
Abdominal computed tomography (CT) demonstrating apple-core mass of the ascending colon.
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CT scan of the abdomen and pelvis showed pericecal inflammatory stranding without pneumatosis concerning cecal typhlitis as well as an "apple-core mass" of the ascending colon near the hepatic flexure concerning colon cancer (Figure 1).
Colonoscopy showing a mass in the proximal transverse colon. Mucosa presents with nodularity, loss of vascular pattern, and diffuse exudates.
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It revealed diffuse friable changes of the colonic wall extending from the cecum to the hepatic flexure and the transverse colon (Figure 2).
H&E, 126x magnification, showing changes of chronic, active colitis including crypt architectural distortion (branching) and focal active cryptitis (white arrow).
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Final pathology from the cecal biopsy specimens showed chronic active colitis with cryptitis, ulceration, and architectural distortion (Figure 3).
(a) CMV immunohistochemical stain, 200x magnification, highlighting both nuclear and cytoplasmic staining (brown chromogen) within the ulcerated granulation tissue. (b) H&E stain, 400x magnification, showing a CMV-infected endothelial cell with dot-like cytoplasmic inclusions (white arrow).
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CMV immunohistochemical staining was positive for CMV type inclusions compatible with CMV colitis (Figure 4).