Systemic pathology: eosinophilic oesophagitis: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Systemic pathology: eosinophilic oesophagitis

Sample item

A 20-year-old man with asthma and eczema has recurrent food impaction and dysphagia. Endoscopy shows concentric rings and longitudinal furrows in the oesophagus, and he does not respond to proton pump inhibitors alone. What would biopsy show?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Dense eosinophils within the squamous epithelium

Eosinophilic oesophagitis is an immune-mediated, antigen-driven disease of atopic patients. Biopsies show a dense intraepithelial eosinophilic infiltrate with basal cell hyperplasia, and the fixed rings give the trachealised oesophagus. Treatment includes topical steroids and dietary elimination.

Option by option

  • A. Multinucleated cells with viral inclusions

    Multinucleated cells with inclusions suggest herpes simplex oesophagitis.

  • B. Non-caseating granulomas

    Granulomas would suggest Crohn disease or sarcoidosis.

  • C. Dense eosinophils within the squamous epithelium (correct)

    Correct. Dense eosinophils infiltrating the squamous epithelium define the disease.

  • D. Columnar epithelium with goblet cells

    Columnar epithelium with goblet cells is Barrett oesophagus, not an eosinophilic condition.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Dense eosinophils within the squamous epithelium. Eosinophilic oesophagitis is an immune-mediated, antigen-driven disease of atopic patients.

Why is "Multinucleated cells with viral inclusions" not the answer?

Multinucleated cells with inclusions suggest herpes simplex oesophagitis.

Why is "Non-caseating granulomas" not the answer?

Granulomas would suggest Crohn disease or sarcoidosis.

Why is "Columnar epithelium with goblet cells" not the answer?

Columnar epithelium with goblet cells is Barrett oesophagus, not an eosinophilic condition.

What concept does this question test?

It tests Systemic pathology: eosinophilic oesophagitis in Pathology. Biopsies show a dense intraepithelial eosinophilic infiltrate with basal cell hyperplasia, and the fixed rings give the trachealised oesophagus. Treatment includes topical steroids and dietary elimination.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Systemic pathology: eosinophilic oesophagitis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.