Pathology

Lollo, Simonetta Di; Tozzini, Silvia

doi:10.1007/978-88-470-2091-7_12

Cited by 2 publications

(8 citation statements)

References 45 publications

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“…Rarely, CMV may present as a mass lesion, or inflammatory pseudotumor, causing luminal obstruction. CMV-infected cells are enlarged (10–15 μ m), with strongly eosinophilic nuclear inclusions, which are surrounded by a clear halo, and small basophilic cytoplasmic inclusions; these cytoplasmic inclusions cause a granular appearance under light microscopy ( Figure 2 ) [ 2 ]. Infected and dead cells may appear mummified and enlarged, but without nuclear inclusions.…”

Section: Resultsmentioning

confidence: 99%

“…Biopsies from the ulcer base are more likely to demonstrate characteristic CMV inclusions, which are usually seen in stromal and endothelial cells, as compared to HSV infection, which manifests in squamous cells [ 3 ]. Necrotizing vasculitis and regenerative mucosal hyperplasia may also be present ( Figure 2 ) [ 2 ]. Immunohistochemistry, FISH, and PCR are ancillary to microscopic diagnosis and offer greater sensitivity in latent infection.…”

Section: Resultsmentioning

confidence: 99%

“…HSV cytopathic effect encompasses (i) homogenous ground-glass nuclei with margination of chromatin, (ii) nuclear molding, (iii) multinucleation, and, rarely, (iv) Cowdry type A nuclear inclusions [ 5 ]. Moreover, HSV-induced ulceration exhibits an inflammatory infiltrate rich in neutrophils and histiocytes, the presence of which should prompt a thorough search for viral cytopathic changes [ 2 ].…”

Section: Resultsmentioning

confidence: 99%

“…Pathologic evaluation of endoscopic biopsy specimens includes light and electron microscopy, special stains, immunohistochemical techniques, fluorescent in situ hybridization (FISH), and polymerase chain reaction (PCR) [ 2 ]. Light microscopy, with hematoxylin and eosin (H & E) staining, is often sufficient to suggest or confirm a diagnosis.…”

Section: Introductionmentioning

confidence: 99%

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Human Immunodeficiency Virus-Associated Gastrointestinal Disease: Common Endoscopic Biopsy Diagnoses

Bhaijee

Subramony

Tang

et al. 2011

Pathology Research International

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The gastrointestinal (GI) tract is a major site of disease in HIV infection: almost half of HIV-infected patients present with GI symptoms, and almost all patients develop GI complications. GI symptoms such as anorexia, weight loss, dysphagia, odynophagia, abdominal pain, and diarrhea are frequent and usually nonspecific among these patients. Endoscopy is the diagnostic test of choice for most HIV-associated GI diseases, as endoscopic and histopathologic evaluation can render diagnoses in patients with non-specific symptoms. In the past three decades, studies have elucidated a variety of HIV-associated inflammatory, infectious, and neoplastic GI diseases, often with specific predilection for various sites. HIV-associated esophageal disease, for example, commonly includes candidiasis, cytomegalovirus (CMV) and herpes simplex virus (HSV) infection, Kaposi's sarcoma (KS), and idiopathic ulceration. Gastric disease, though less common than esophageal disease, frequently involves CMV, Mycobacterium avium-intracellulare (MAI), and neoplasia (KS, lymphoma). Small bowel biopsies and intestinal aspirates from HIV-infected patients often show HIV enteropathy, MAI, protozoa (Giardia, Isospora, Cryptosporidia, amebae, Microsporidia), and helminths (Strongyloides stercoralis). Colorectal biopsies demonstrate viral (CMV, HSV), bacterial (Clostridia, Salmonella, Shigella, Campylobacter), fungal (cryptococcosis, histoplasmosis), and neoplastic (KS, lymphoma) processes. Herein, we review HIV-associated GI pathology, with emphasis on common endoscopic biopsy diagnoses.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Human Immunodeficiency Virus-Associated Gastrointestinal Disease: Common Endoscopic Biopsy Diagnoses

Bhaijee

Subramony

Tang

et al. 2011

Pathology Research International

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“… 17 Furthermore, HIV-induced ulcerations present with viral cytopathic effects on histopathology, none of which was noted in our patient. 18 It is possible that ART initiation caused the GI symptomology in our patient and the terminal ileum ulceration was found incidentally. Close follow-up is advised for up to 6–8 months with repeat laboratory tests, imaging, and colonoscopy warranted based on clinical progression.…”

Section: Discussionmentioning

confidence: 85%

Idiopathic Terminal Ileal Ulceration Mimicking Crohn's in the Setting of Antiretroviral Therapy Initiation

et al. 2020

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Antiretroviral therapy (ART) has precipitously decreased the morbidity associated with human immunodeficiency virus but can unmask and exacerbate opportunistic infections and autoimmune diseases. Various diseases have been reported in association with ART initiation, but there is scant literature describing inflammatory colitis in the setting of ART initiation. We present a 39-year-old man with chronic untreated human immunodeficiency virus and central nervous system toxoplasmosis who developed persistent diarrhea after initiation of ART. A comprehensive infectious workup was negative. Computed tomography demonstrated terminal ileum enteritis, which was confirmed by colonoscopy. Biopsy of the terminal ileum revealed fibrinous exudate and granulation tissue.

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Pathology

Cited by 2 publications

References 45 publications

Human Immunodeficiency Virus-Associated Gastrointestinal Disease: Common Endoscopic Biopsy Diagnoses

Human Immunodeficiency Virus-Associated Gastrointestinal Disease: Common Endoscopic Biopsy Diagnoses

Idiopathic Terminal Ileal Ulceration Mimicking Crohn's in the Setting of Antiretroviral Therapy Initiation

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