PMC8604585_01
Endoscopy showing the gastric ulcer.
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An esophagogastroduodenoscopy (EGD) revealed a large, irregularly shaped, deep ulcer in the gastric antrum, involving the angular incisure and the prepyloric region, with a deformation and narrowing of the pylorus (Figure 1).
Computed tomography showing antral-wall thickening and mesenteric lymphadenopathy (arrow).
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The patient's histological findings. (a) H&E staining showing chronic gastritis and scattered large cells with intranuclear and intracytoplasmatic inclusion bodies (arrows); (b) positive IHC in a representative duodenal specimen; (c) H&E staining showing duodenitis and large cells with inclusion bodies (arrow).
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Staining of the gastric biopsy specimens with hematoxylin and eosin (H&E) revealed severe chronic active gastritis with ulceration and scattered large cells with inclusion bodies, characteristic of CMV infection (Figure 3(a)). Immunohistochemistry (IHC) using monoclonal CMV antibodies was also positive (Figure 3(b)). Duodenal mucosa staining yielded duodenitis and scattered large cells with inclusion bodies (Figure 3(c)).
Follow-up endoscopy showing a residual scar.
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Follow-up EGD, carried 50 days after the initiation of treatment, was only notable for a residual antral scar (Figure 4).