PMC4531909_01
The gastroscopic findings before (A) and after (B) intravenous ganciclovir treatment.. A. On the 2nd portion of the duodenum, an octopus sucker-like elevated lesion with central hyperemic erosion was noted.. B. After treatment with ganciclovir, these erosions were healed.
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By gastroscopic finding, the stomach showed multiple hyperemic patchy erosions mainly in the greater curvature of the body and, on the second portion of the duodenum, an octopus sucker-like elevated lesion with central hyperemic erosion and several hyperemic flat erosive lesions were noted(Fig. 1-A). At the end of 3 week's treatment, follow-up gastrofibroscopy revealed healed erosions(Fig. 1-B).
A. Inflamed mucosa with degenerating surface epithelium and large cytomegalic cells with smudged nuclei in micronecrotic background (H & E, x400).. B. Immunoperoxidase staining for CMV demonstrates one cytomegalic cell with strongly positive reactivity in both cytoplasm and nucleus (x400).
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Duodenal mucosal biopsy revealed cytomegalic cells which showed a large, densely staining nucleus and abundant cytoplasms with intracytoplasmic inclusion body(Fig. 2-A). Immunochemical staining for CMV antigens using monoclonal antibodies confirmed the diagnosis of CMV duodenitis(Fig. 2-B).