Water Under the Bridge I

This is the first part of a two-part case.

You are doing an away rotation in China where many people smoke, drink, and eat very little fruits and vegetables. You see a patient with longstanding GERD and gastritis that has been untreated for 20 years. He is presenting with weight loss. Upon further inquiry, you find that he has solid food dysphagia as well as anorexia. Apples, meat, hard-boiled eggs, and bread seem to "stick" in the patient's throat. The patient says his voice has become hoarse.

Endoscopy shows this at the gastro-esophageal junction:


Challenge: What is the diagnosis?

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