A 45-year-old man presents with progressive dysphagia to solids over the past 3 months. He has had chronic heartburn and regurgitation for 12 years, managed with omeprazole 20 mg daily for the past 8 years. He denies odynophagia, fever, or recent antibiotic use. Vital signs are stable. Upper endoscopy shows a salmon-colored mucosa in the distal esophagus extending 6 cm above the gastroesophageal junction, with areas of irregular nodularity. Biopsies from the distal esophagus demonstrate columnar epithelium with intestinal metaplasia and high-grade dysplasia. Which of the following is the most likely diagnosis?
- A)Esophageal adenocarcinoma
- B)Barrett esophagus with high-grade dysplasiaGABARITO
- C)Infectious esophagitis secondary to Candida albicans
- D)Medication-induced esophagitis from omeprazole
- E)Achalasia with secondary candidal infection
Explicação
Barrett esophagus is defined histologically as replacement of normal squamous epithelium with columnar epithelium containing intestinal metaplasia in the distal esophagus. The patient's long-standing GERD, chronic PPI use, and endoscopic finding of salmon-colo... Ver explicação completa e trilha adaptativa →