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Black lesions in the oesophagus
  1. Milan Patel1,
  2. Irene Shyu2,
  3. Mark Mochel2,
  4. George Smallfield3
  1. 1 Department of Internal Medicine, Virginia Commonwealth University Health Center, Richmond, Virginia, USA
  2. 2 Department of Pathology, Virginia Commonwealth University Health Center, Richmond, Virginia, USA
  3. 3 Division of Gastroenterology and Hepatology, Virginia Commonwealth University Health Center, Richmond, Virginia, USA
  1. Correspondence to Dr Milan Patel, Department of Internal Medicine, Medical College of Virginia, Richmond, VA 23219, USA; milan.patel{at}

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A 69-year-old Trinidadian woman with a past medical history of gastro-oesophageal reflux disease (GERD) presented with a 2-week history of dysphagia. Physical examination did not reveal any cutaneous or mucocutaneous lesions. Neurological exam also was normal. There were no laboratory abnormalities. A CT scan showed circumferential wall thickening and moderate patulous proximal oesophagus without any distal oesophageal findings or abnormal findings in the chest or abdomen. A barium oesophagram revealed severe oesophageal dysmotility and GERD. Given the dysphagia and CT findings, an oesophagogastroduodenoscopy (EGD) was performed. The EGD revealed pigmented mucosa in the lower …

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  • Contributors GS completed the oesophagogastroduodenoscopy (EGD) and performed the biopsies. IS and MM performed the analysis on the biopsies and completed the staining. MP compiled the data and wrote the manuscript. GS, IS and MM edited the manuscript. MP is the article guarantor.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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