PMC5340719_01
EGD showing an ulcer with associated gastritis in the cardia of the stomach.
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F1
Esophagogastroduodeno-scopy (EGD) showed an ulcer with associated gastritis in the cardia of the stomach; biopsies were negative for Helicobacter pylori (Figure 1).
(A) Coronal and (B) axial CT showing perforation at the ulcer site and a fistulous connection to a splenic abscess.
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F2
Abdominal/pelvic computed tomography (CT) showed a perforation at the ulcer site and a fistulous connection to a splenic abscess (Figure 2).
Hematoxylin and eosin stain of gastric biopsy demonstrating CMV "owl's eye" appearance.
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F3
A repeat EGD was undertaken to perform additional biopsies, which were negative for malignancy but revealed CMV gastritis with extensive ulceration (Figure 3).
Positron emission tomography scan demonstrating diffuse large B-cell lymphoma.
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F4
Given the concern for malignancy, a CT-guided biopsy was positive for diffuse large B-cell lymphoma and positron emission tomography-CT showed diffuse abdominal disease (Figure 4).