Discrete gastrointestinal mass lesions caused by cytomegalovirus in patients with AIDS: report of three cases and review

We report the detailed clinical features of discrete mass lesions of the gastrointestinal tract caused by cytomegalovirus in three patients who had the acquired immunodeficiency virus syn-drome. The disease occurred in the fundus of the stomach in one patient and in the cecum in the other two persons. The symptoms as well as radiographic and endoscopic findings in each case are described and are shown to be indistinguishable from those resulting from a neoplasm. The diagnosis was established by the presence of inflammation with cytomegalovirus-like inclusions and confirmed by immunoperoxidase staining. Cytomegalovirus infection should be considered, along with Kaposi's sarcoma and lymphoma, as a cause of focal mass lesions of the alimentary tract in persons infected with HIV. Cytomegalovirus (CMV) frequently co-infects HIV-sero-positive persons and is present in the gastrointestinal tract of 15%-43 % of patients who have the acquired immunodefi-ciency syndrome (AIDS) [1-3]. Only a portion of these indi-viduals, however, exhibit pathological evidence of disease, most commonly diffuse erosive esophagitis or colitis [4-6]