(a–c) A 49-year-old male patient presented with 1-month history of epigastric discomfort, loose stools, painful perianal swelling, productive cough, marked loss of appetite, and loss of weight. Routine hematological and biochemical laboratory investigations were within normal limits. X-ray chest, USG abdomen, and CT scan were also not contributory. Upper GI endoscopy showed candidal esophagitis, distortion of gastric folds in the body, and the antrum with flat ulcerated lesions. Histopathological examination of endoscopic gastric biopsy showed marked architectural distortion and nuclear pleomorphism of gastric glands. On this endoscopic biopsy, histopathological diagnosis of adenocarcinoma stomach was offered. Gastrectomy was performed. The gastrectomy specimen showed a 5 × 3 × 1.5 cm growth, 3 cm distal to resected antral region. The overlying mucosa was flattened with focal areas of congestion and ulceration. Histological examination showed ulcerated gastric mucosa. The gastric glands adjacent to the ulcerated areas showed disorganization and stratification suggestive of psuedoadenomatous hyperplasia along with reactive atypia of lining epithelial cells of gastric mucosa. The gastric mucosa also showed CMV gastritis along with concomitant infestation by Cryptosporidium as another opportunistic infection. On subsequent investigations the patient was found to be HIV positive (a HE ×400, b IHC for CMV ×400 and c HE ×1000) (Contributor: Prof Harsh Mohan, Head of Department Pathology, Government Medical College, Chandigarh, India)