Herpes simplex lesion mimicking left upper lobe bronchial tumour

Dantas, George Caldas; Shoji, Hamilton; Hoelz, C; Funari, Marcelo Buarque de Gusmão; Szarf, Gilberto

doi:10.1136/thoraxjnl-2017-210026

Cited by 6 publications

(4 citation statements)

References 2 publications

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“…HSV was recognized as the leading cause of proctitis in patients with HIV [11], and all reported tumor-like hypertrophic lesions caused by HSV including our case were patients with HIV [6,12,13]. Masslike lesions caused by HSV infection can be a mimicker of malignancy clinically and have been reported in other anatomic sites such as nasal cavity [12], bronchial [14], and conjunctiva [15]. Interestingly, the first case of HSV1 proctitis mimicking rectal cancer in a patient with HIV has recently reported in English literature by Ayoade et al [13], and biopsies revealed similar lymphoplasmacytic and eosinophilic infiltrate seen in our patient.…”

Section: Discussionsupporting

confidence: 53%

Inflammatory pseudotumor associated with HSV infection of rectal vascular endothelium in a patient with HIV: a case report and literature review

Bai

Maykel²,

Yang

2020

BMC Infect Dis

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Background: Herpes simplex virus (HSV) typically infects oral or anogenital squamous epithelium and causes blisters and ulcerations. Here we reported an unusual case of HSV induced exuberant rectal inflammatory pseudotumor with vascular endothelial involvement. Case presentations: A 52-year old man with HIV presented with abdominal pain, rectal drainage and constipation. Proctoscopy and CT scans revealed an 8 × 5 × 4 cm circumferential, mid-lower rectal mass that was concerning for malignancy. PET-CT showed mild to moderate FDG uptake of the rectal mass. Repeated biopsies showed exuberant lymphoplasmacytic inflammation with rich eosinophils and necrosis in the submucosa and scattered single or multinucleated viral inclusions in vascular endothelial cells that were positive for HSV by immunostains. There was no evidence of malignancy on histology or by immunostains. The patient started valacyclovir for three weeks and symptoms resolved after the antiviral therapy. Follow-up CT and sigmoidoscopy with biopsy revealed no rectal mass or drainable collection. Conclusions: HSV may present as proctitis with exuberant inflammatory response and mass-like lesion, and damages vascular endothelial cells in patients with HIV. The HSV-associated mass-like lesion can be effectively treated by 3-week valacyclovir.

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Section: Discussionsupporting

confidence: 53%

Inflammatory pseudotumor associated with HSV infection of rectal vascular endothelium in a patient with HIV: a case report and literature review

Bai

Maykel²,

Yang

2020

BMC Infect Dis

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“…2 It was postulated that the virus could enter the lower respiratory tract by aspiration or contiguous propagation after oropharynx reactivation, and spread may occur following orotracheal intubation. 3 HSV-pneumonia diagnosis is based on microscopic findings and characteristic cytopathic cellular changes in specimens obtained by bronchial brushing, bronchoalveolar lavage, or tissue biopsy, such as intranuclear inclusions or homogenization of nuclear chromatin. 4 Acyclovir is the drug of choice for an infection of herpes simplex virus.…”

Section: Case Reportmentioning

confidence: 99%

Pulmonary Herpes Simplex Infection: A Case Report

Zainulabid

Razak

Abdullah

et al. 2020

Int. J. Hum. Health Sci.

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Pulmonary herpes simplex infection is rarely reported. To date, there is a paucity of literature on this infection. This case study describes a 64-year-old male with a background history of diabetes mellitus and hypertension who was intubated for acute respiratory failure. The managing team had difficulty to wean his oxygenation thus decided for bronchoscopy examination which showed suspicious growth at middle lobe of the right lung. Repeated bronchoscopy by pulmonologist revealed a nodular ‘warty’ appearance lesion at right bronchus intermedius. His biopsy revealed histopathological changes consistent with herpes simplex infection.International Journal of Human and Health Sciences Vol. 05 No. 01 January’21 Page: 112-114

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“…Although not exclusively, HSV-2 is more commonly known to manifest in the anorectal region as painful, itchy, vesicular, and sometimes ulcerated skin lesions which are occasionally described as nodular, mimicking either condyloma, or other anal/perianal tumor [3][4][5]. Additionally, HSV infection has been reported to present as a pseudotumoral lesion in other sites including the genital tract, conjunctiva, nasal cavity, and bronchus [5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Herpes Proctitis in Men Mimicking Rectal Adenocarcinoma: Two Cases of an Easily Overlooked Diagnosis in the Proximal Rectum

Sun

Malhotra

Ananthakrishnan

et al. 2023

Case Reports in Pathology

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We describe two cases of rectal herpes simplex virus (HSV) infection in men that clinically mimicked rectal adenocarcinoma. Herpes infection in this location more commonly presents as an anal mass with viral inclusions in squamous epithelial cells. We report these cases to increase awareness of the unusual presentation as a proximal rectal mass with viral inclusions in endothelial cell nuclei. One patient was HIV-positive, and the other one had a history of having sex with men (MSM). Both patients had a thickened rectal wall with prominent lymphadenopathy on computed tomography (CT) scan, suspecting for malignancy. Biopsy showed abundant granulation tissue, necrosis, and inflammatory infiltrate composed predominantly of lymphocytes with admixed numerous plasma cells, eosinophils, and neutrophils. Rare granulation tissue vessels were lined by endothelial cells with nuclear molding and chromatin margination, and nuclei that were positive for HSV immunohistochemistry (IHC). One patient had confirmatory viral culture from biopsy of the ulcerated rectal mass. Both patients had symptom resolution following treatment for HSV. HSV should be considered in the differential diagnosis of rectal inflammatory masses, particularly in immunocompromised, HIV-positive, and MSM patients.

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Herpes simplex lesion mimicking left upper lobe bronchial tumour

Cited by 6 publications

References 2 publications

Inflammatory pseudotumor associated with HSV infection of rectal vascular endothelium in a patient with HIV: a case report and literature review

Inflammatory pseudotumor associated with HSV infection of rectal vascular endothelium in a patient with HIV: a case report and literature review

Pulmonary Herpes Simplex Infection: A Case Report

Herpes Proctitis in Men Mimicking Rectal Adenocarcinoma: Two Cases of an Easily Overlooked Diagnosis in the Proximal Rectum

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