A 48-Year-Old Man Comes to the Emergency Department Due to 3

A 48-year-old man comes to the emergency department due to 3 days of progressively worsening retrosternal burning chest pain, dysphagia, and odynophagia.  His medical problems include hypertension and end-stage renal disease.  He underwent cadaveric renal allograft transplantation 8 months ago.  The patient's temperature is 38.3 C (101 F) , blood pressure is 130/80 mm Hg, and pulse is 94/min.  His BMI is 31 kg/m².  The oral mucosa is pink and moist without ulcerations.  Cardiopulmonary examination is normal.  The abdomen is soft with mild epigastric tenderness.  The patient's leukocyte count is 4,200/mm³.  An esophagogastroduodenoscopy demonstrates linear, shallow ulcerations in the lower esophagus.  Which of the following is most likely to be seen on esophageal biopsy?

A) Enlarged cells with intranuclear inclusions
B) Metaplastic columnar epithelium
C) Mucosal tear without acute inflammation
D) Urease-producing organisms
E) Yeast with polysaccharide capsule

Correct Answer:

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