Your browser doesn't support javascript.
loading
Clinicopathologic Features of Varicella Zoster Virus Infection of the Upper Gastrointestinal Tract.
Mostyka, Maria; Shia, Jinru; Neumann, William L; Whitney-Miller, Christa L; Feely, Michael; Yantiss, Rhonda K.
Afiliação
  • Mostyka M; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York Presbyterian Hospital.
  • Shia J; Department of Pathology, Memorial Sloan Kettering Cancer Center, New York.
  • Neumann WL; Mid-Valley Pathology, Weslaco, TX.
  • Whitney-Miller CL; Department of Pathology and Laboratory Medicine, University of Rochester, Rochester, NY.
  • Feely M; Department of Pathology, Immunology, and Laboratory Medicine, University of Florida, Gainesville, FL.
  • Yantiss RK; Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York Presbyterian Hospital.
Am J Surg Pathol ; 45(2): 209-214, 2021 02 01.
Article em En | MEDLINE | ID: mdl-32826528
ABSTRACT
Reactivation of latent varicella zoster virus (VZV) may be limited to a dermatome or involve multiple organs, including the gastrointestinal tract. Although gastrointestinal manifestations of disseminated zoster have been likened to those of herpes simplex virus (HSV), histologic features of VZV-related injury to the tubular gut are not well-documented. We performed this study to describe the clinicopathologic features of VZV-related gastrointestinal injury. We identified 6 such patients with VZV infection. All involved the upper gastrointestinal tract, affecting the esophagus (n=3), stomach (n=2), or both (n=1). All patients were immunocompromised adults with hematologic malignancies (n=5) or a heart transplant (n=1); 3 with hematologic malignancies had received stem cell transplants. Five patients had cutaneous and gastrointestinal zoster; 1 had gastrointestinal disease alone. When compared with 14 HSV-related esophagitis controls, there were several notable differences. VZV caused hemorrhagic ulcers with nodularity or erythema, whereas HSV produced round, shallow ulcers on a background of nearly normal mucosa (P=0.01). VZV-related ulcers featured fibrin-rich, pauci-inflammatory exudates compared with the macrophage-rich exudates of HSV (P=0.003). The cytopathic changes of VZV were present at all levels of the squamous epithelium, especially in a peripapillary distribution. In contrast, HSV inclusions were located in the superficial layers (P=0.003) and detached keratinocytes. Unlike HSV, VZV involved the stomach, producing hemorrhage accompanied by striking apoptosis in the deep glands. We conclude that VZV produces unique patterns of gastrointestinal injury that facilitate its diagnosis. Recognition of gastrointestinal VZV infection is important because it heralds potentially life-threatening disseminated disease.
Assuntos

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hospedeiro Imunocomprometido / Trato Gastrointestinal Superior / Herpes Zoster Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Hospedeiro Imunocomprometido / Trato Gastrointestinal Superior / Herpes Zoster Idioma: En Ano de publicação: 2021 Tipo de documento: Article