Gastroenterology clinical image challenge: An 88-year-old man was referred to our hospital for severe anemia. Laboratory data showed a hemoglobin of 5.1 g/dL, mean corpuscular volume of 106.5 fL and Fe of 44 μg/dL. The patient received hormone and chemotherapy for prostate cancer 15 years ago. He was treated with surgical resection for right inguinal extramammary Paget’s disease one year ago. Physical examination revealed no skin lesion. Computed tomography scan showed no lymph node metastasis, and no mass lesion in prostate, liver or lung. Esophagogastroduodenoscopy revealed multiple reddish protrusion with erosion in the greater curvature of the gastric body (figure). Narrow-band imaging with magnifying revealed an irregular microvessel pattern and an irregular microsurface pattern. Endosonographically, the lesions were isoechoic and were confined to the mucosa.
What is the diagnosis?
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