Numerous gastric nodules in a leukaemia patient

Clinical presentation An 81-year-old white man presented with 2 weeks of odynophagia and dysphagia to solids and liquids limiting his oral intake and leading to 5 lb weight loss. He has a history of chronic myelomonocytic leukaemia with recent transition to myelofibrosis, uncontrolled gastro-oesophageal reflux disease (GORD) and chronic obstructive pulmonary disease on home oxygen. He denied fever, chills, nausea, vomiting, early satiety, abdominal pain, melena or haematemesis. The physical examination was unremarkable, and he had no oral thrush. His laboratory tests showed pancytopenia (absolute neutrophils count 62 cells/mm3, haemoglobin 80 g/L, platelets 17 000 cells/mm3). A CT chest showed diffuse oesophageal wall thickening and normal stomach. Oesophagogastroduodenoscopy demonstrated erosive oesophagitis with several distal oesophageal ulcers. Biopsies were negative for viral particles and confirmed reflux disease. There were numerous non-bleeding, approximately 1 cm erythematous nodules throughout the entire stomach (figure 1) that were biopsied. Question What is...
Source: Gut - Category: Gastroenterology Authors: Tags: GUT Snapshot, Gut Editor ' s quiz: GI snapshot Source Type: research