The specimen is a length of oesophagus, showing an irregular lumen in which there are areas of
leukoplakia. There is irregular thickening of the wall, with apparent muscular hypertrophy.
This area of the oesophagus was resected at the age of 24; the patient presented at the
age of 2 with a three-month history of vomiting at all meals associated with an hypochromic
anaemia. At the age of 3 there was still difficulty swallowing and an X-ray showed an oesophageal
stricture with a congenital hiatus hernia. Some 5.00 to 6.00 cm. below the level of the pharynx
there was a stricture 2.5 cm. long and there was evidence of anomalous acid secretion. Over the
intervening years the lesion was dilated and finally resected. The patient remains well.