Evidence map›Paper›PMID 31931725›Full record

ArticleBMC gastroenterology2020

A rare case of Epstein-Barr virus-positive mucocutaneous ulcer that developed into an intestinal obstruction: a case report.

Nozomi Morita, Chiaki Okuse, Keigo Suetani, Hiroyasu Nakano, Tetsuya Hiraishi, Shinya Ishigooka, Shuzo Mori, Tsukasa Shimamura, Takeshi Asakura, Junki Koike and 2 more

Open access · goldAbstract readCase Reports
In one paragraph

Article in BMC gastroenterology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
1.1field-weighted citation impact, top 21% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

10 citing papers in PubMed, 15 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Nozomi MoritaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, 1-30-37, Shukugawara, Tama-Ku, Kawasaki, Japan.
Chiaki OkuseDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, 1-30-37, Shukugawara, Tama-Ku, Kawasaki, Japan. c2okuse@marianna-u.ac.jp.
Keigo SuetaniDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, 1-30-37, Shukugawara, Tama-Ku, Kawasaki, Japan.
Hiroyasu NakanoDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, 1-30-37, Shukugawara, Tama-Ku, Kawasaki, Japan.
Tetsuya HiraishiDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, 1-30-37, Shukugawara, Tama-Ku, Kawasaki, Japan.
Shinya IshigookaDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, 1-30-37, Shukugawara, Tama-Ku, Kawasaki, Japan.
Shuzo MoriDivision of Gastroenterological and General Surgery, Department of surgery, Kawasaki Municipal Tama Hospital, 1-30-37, Shukugawara, Tama-Ku, Kawasaki, Japan.
Tsukasa ShimamuraDivision of Gastroenterological and General Surgery, Department of surgery, Kawasaki Municipal Tama Hospital, 1-30-37, Shukugawara, Tama-Ku, Kawasaki, Japan.
Takeshi AsakuraDivision of Gastroenterological and General Surgery, Department of surgery, Kawasaki Municipal Tama Hospital, 1-30-37, Shukugawara, Tama-Ku, Kawasaki, Japan.
Junki KoikeDepartment of Pathology, Kawasaki Municipal Tama Hospital, 1-30-37, Shukugawara, Tama-Ku, Kawasaki, Japan.
Fumio ItohDivision of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-Ku, Kawasaki, Japan.
Michihiro SuzukiDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Kawasaki Municipal Tama Hospital, 1-30-37, Shukugawara, Tama-Ku, Kawasaki, Japan.
St. Marianna University School of Medicine · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEpstein-Barr virus-positive mucocutaneous ulcer (EBV-MCU) is a new category of mature B-cell neoplasms. Ulcers occur in the oropharyngeal mucosa, skin, and gastrointestinal tract. The onset of EBV-MCU is suggested to be related to the decreased immunity of the patient, the causes of which include the use of immunosuppressive agents and aging. EBV-MCU may regress spontaneously and it often has a benign course after the dose reduction or discontinuation of immunosuppressive agents or during follow-up. Here, we report the case of a patient who required surgical resection for the intestinal obstruction arising from EBV-MCU. CASE PRESENTATION: A Japanese elderly male visited our hospital with chief complaints of a palpable mass and dull pain in the left upper quadrant, loss of appetite, and weight loss. Although abdominal computed tomography and total colonoscopy (TCS) revealed a tumor with circumferential ulcer in the transverse colon, histopathological analysis of a biopsy specimen of this lesion showed only nonspecific inflammation. Because the tumor spontaneously regressed during the time he underwent tests to obtain a second opinion from another hospital, TCS was reperformed on the patient. TCS revealed that the tumor decreased in size and the inflammatory changes in the surrounding mucosa tended to improve; however, tightening of the surrounding mucosa due to scarring was observed. Another histopathological analysis of a biopsy specimen showed widespread erosion of the mucosa and the formation of granulation tissue with marked infiltration of various inflammatory cells into the mucosal tissue of the large intestine. Moreover, some of the B-lymphocyte antigen CD20-positive B cells were also positive for EBV-encoded small RNA-1, suggesting the possibility of EBV-MCU. Later, the tumor developed into an intestinal obstruction; thus, the transverse colon was resected. Histopathological analysis of the resected specimen demonstrated scattered Hodgkin and Reed-Sternberg-like multinucleated large B cells in addition to EBER-1-positive cells. The patient was finally diagnosed as having EBV-MCU.

conclusionsThis is the first report of a case of EBV-MCU that developed into an intestinal obstruction requiring surgical resection. It is necessary to consider the possibility of EBV-MCU when examining an ulcerative or tumorous lesion in the gastrointestinal tract.

Indexed as

Herpesvirus 4, HumanAged, 80 and overColon, TransverseEpstein-Barr Virus InfectionsHumansIntestinal MucosaIntestinal ObstructionMaleUlcerAgingEpstein–Barr virus-positive mucocutaneous ulcer (EBV-MCU)ImmunosuppressionIntestinal obstructionSurgical resection

Identifiers

PMID31931725
PMCPMC6958744
OpenAlexW3006012644

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.