Week 18 Quiz 2GIpathology C Elsevier 2005 A-yearod man has compained of"meals for the past decade.remarkable Upper gastrointestinal endoscopy is performed,and an esophageal biopsy specimen is taken from an erythematous area of velvety mucosa just above the gastroes ophageal junction is shown above.Microscopically,the mucosa shows columnar metaplasia with goblet cells.Which of the following MOSI LIKELY produced these findings? A.Achalasia B.Esophageal varices C.Gastroesophageal reflux disease D.Iron deficiency anemia E.Radiation therapy Ans:C Columnar metaplasia of the lower quence of F。12080)n740i y he ac Achalasia fthe lower ES) e the lev of the LES.Varices result from long st Although er is not present.Upper esophageal webbi ng may rareb columnar metaplasia. Week 18 Quiz 2GIpathology 1. A 49-year-old man has complained of "heartburn" after meals for the past decade. There are no remarkable findings on physical examination. Upper gastrointestinal endoscopy is performed, and an esophageal biopsy specimen is taken from an erythematous area of velvety mucosa just above the gastroesophageal junction is shown above. Microscopically, the mucosa shows columnar metaplasia with goblet cells. Which of the following MOST LIKELY produced these findings? A. Achalasia B. Esophageal varices C. Gastroesophageal reflux disease D. Iron deficiency anemia E. Radiation therapy Ans: C Columnar metaplasia of the lower esophageal mucosa, also called Barrett’s esophagus, is a consequence of chronic gastroesophageal reflux disease. The metaplasia may be accompanied by inflammation. Achalasia refers to failure of relaxation of the lower esophageal sphincter (LES). This gives rise to progressive dilation of the esophagus above the level of the LES. Varices result from long standing portal hypertension. Although there may be associated inflammation, columnar metaplasia is not present. Upper esophageal webbing may rarely accompany iron deficiency. Radiation therapy may produce inflammation and fibrosis eventually but there is no columnar metaplasia