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Figure 1. A 48-year-old man infected with the human immunodeficiency virus had had recurrent painful ulcers in his mouth and esophagus for several years. Biopsies of the lesions were nondiagnostic. Odynophagia and substernal chest pain responded to repeated courses of prednisone for presumed idiopathic esophageal ulcers. A subsequent recurrence led to a weight loss of 14 kg. The CD4+ cell count was 9 per cubic millimeter. Esophagoscopy revealed extremely large coalescing ulcers of the distal esophagus, effectively resulting in a "double-barreled" lumen (Panel A), as well as evidence of Barrett's esophagus. A barium swallow (Panel B) confirmed the presence . . . [Full Text of this Article] |
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