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

Jin Wuk Gwak; Jiwon Yoo; Seong O Suh; Jaeyeon Kim; In Soo Oh; Ji Yoon Bae

doi:10.4166/kjg.2019.73.3.177

Journal List > Korean J Gastroenterol > v.73(3) > 1119380

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Gwak, Yoo, Suh, Kim, Oh, and Bae: Benign Gastric Ulcer with Epstein-Barr Virus Infection Mimicking Malignant Gastric Ulcer

Case Report

The Korean Journal of Gastroenterology 2019; 73(3): 177-181.

Published online: 27 March 2019

DOI: https://doi.org/10.4166/kjg.2019.73.3.177

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

Jin Wuk Gwak, Jiwon Yoo

, Seong O Suh, Jaeyeon Kim, In Soo Oh, Ji Yoon Bae¹

Department of Internal Medicine, National Police Hospital, Seoul, Korea.

¹Department of Pathology, National Police Hospital, Seoul, Korea.

Correspondence to: Jiwon Yoo, Department of Internal Medicine, National Police Hospital, 123 Songi-ro, Songpa-gu, Seoul 05715, Korea. Tel: +82-2-3400-1519, Fax: +82-2-3400-1680, outis@police.go.kr

Received 7 June 2018 Revised 9 August 2018 Accepted 21 August 2018

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Epstein-Barr virus infections, Stomach ulcer, Peptic ulcer, In situ hybridization, Helicobacter pylori

Figures and Tables

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.

Fig. 2

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

Fig. 3

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

Fig. 4

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

Fig. 5

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

Notes

^{Financial support} None.

^{Conflict of interest} None.

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ORCID iDs: Jiwon Yoo
https://orcid.org/0000-0003-0337-158X
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