Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access
Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc
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Case Report

Volume 11, Number 5, October 2018, pages 383-387

An Unusual Case of Gastritis in One Patient Receiving PD-1 Blocking Therapy: Coexisting Immune-Related Gastritis and Cytomegaloviral Infection


Figure 1.
Figure 1. Endoscopic features of the stomach. Esophagogastroduodenoscopy (EGD) revealed diffuse, nodular, erythematous and ulcerated mucosa in the antrum (a) with narrowing of the pyloric channel (b).
Figure 2.
Figure 2. Histological features of immunotherapy-associated gastritis and cytomegaloviral (CMV) infection. The antral mucosa showed marked mononuclear inflammatory cell infiltration in the lamina propria (a, hematoxylin & eosin stain (H&E), ×40), crypt apoptosis (b, H&E stain, ×400), apoptotic abscesses (c, H&E stain, ×400), crypt epithelial lymphocytosis (d, H&E stain, ×200) and neutrophilic infiltration in crypt epithelium (e, H&E stain, ×400). Focal erosion and ulceration were noted (f, H&E stain, ×40). In addition, a few prominent lymphoid aggregates were noted in the lamina propria (f, H&E stain, ×40). The glandular epithelium showed regenerative changes (a). No atypia was noted for lymphocytes (d, f). A few cytomegalovirus-infected cells were noted on routine stain (g, H&E stain, ×400) and confirmed by immunohistochemistry (h, immunoperoxidase stain, ×400). Immunohistochemistry for CD3 and CD20 revealed a mixed population of T cells and B cells with T cells primarily in the crypt epithelium and B cells in the lamina propria (i, immunoperoxidase stain, ×200; j, immunoperoxidase stain, ×100).