Korean J Gastroenterol.  2019 Mar;73(3):177-181. 10.4166/kjg.2019.73.3.177.

Benign Gastric Ulcer with Epstein-Barr Virus Infection Mimicking Malignant Gastric Ulcer

• Gwak JW
• Yoo J
• Suh SO
• Kim J
• Oh IS
• Bae JY

• KMID: 2442084
• DOI: http://doi.org/10.4166/kjg.2019.73.3.177

Abstract

Epstein-Barr virus (EBV) is the cause of infectious mononucleosis, which is characterized by fever, lymphadenopathy, and sore throat. On the other hand, gastrointestinal symptoms of EBV infection like dyspepsia, abdominal pain are non-specific and rarely encountered, which means it is difficult to diagnose gastric involvement of EBV infection without suspicion. The relation between gastric carcinoma and gastric lymphoma associated with EBV infection is well defined, but relations with other EBV-associated gastrointestinal diseases such as gastritis and peptic ulcer disease have rarely been reported. We report a case of benign gastric ulcer with EBV infection confirmed by endoscopic and histological findings.

Keyword

Epstein-Barr virus infections; Stomach ulcer; Peptic ulcer; In situ hybridization; Helicobacter pylori

MeSH Terms

Abdominal Pain
Dyspepsia
Epstein-Barr Virus Infections
Fever
Gastritis
Gastrointestinal Diseases
Hand
Helicobacter pylori
Herpesvirus 4, Human*
In Situ Hybridization
Infectious Mononucleosis
Lymphatic Diseases
Lymphoma
Peptic Ulcer
Pharyngitis
Stomach Ulcer*

Figure

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  Fig. 1 Initial endoscopic examination revealed a large ulcer with thick yellowish exudate and an irregular margin on the lesser curvature of antrum of the stomach.

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  Fig. 2 Histopathological findings showing chronic active gastritis with necrotic detritus (H&E, ×100).

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  Fig. 3 Immunohistochemistry results of the gastric specimen were negative for pan cytokeratin [AE1/AE3] (A) and L26 (B) (original magnification, ×40).

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  Fig. 4 EBER in situ hybridization demonstrated positive signals (original magnification, ×200). EBER, Epstein-Barr virus-encoded RNA.

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  Fig. 5 Follow-up esophagogastroduodenoscopy at 6 months after ulcer treatment showed a healed, reddish scar had replaced the ulcer.

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