Unusual endoscopic finding

Yellowish lesions in the oesophagus

CLINICAL PRESENTATION: A 51-year-old man, who had no previous disease, underwent a screening oesophagogastroduodenoscopy, which revealed multiple yellowish lesions in the middle thoracic oesophagus. All lesions were ≤3 mm in size and slightly elevated. Each lesion showed one or two white protrusions on the surface (figure 1). We observed that one lesion looked obviously different from the others and showed yellowish granular spots (figure 2). A biopsy was performed on a representative lesion among the slightly elevated yellowish lesions with white protrusions (figure 3). A biopsy was repeated on a lesion showing yellowish granular spots (figure 4). Blood tests which were examined on the same day, including triglyceride and cholesterol, were within normal limits. gutjnl;68/1/39/F1F1F1Figure 1Slightly elevated yellowish lesions with white protrusions in the middle thoracic oesophagus. gutjnl;68/1/39/F2F2F2Figure 2A lesion showing yellowish granular spots in the middle thoracic oesophagus. QUESTION: What is the diagnosis?