25th August 2020

A 78-year-old man presents to his General Practitioner with the sensation of a lump in his throat

A 78-year-old man presents to his General Practitioner with the sensation of a lump in his throat. He noticed it around 4 months ago and has had progressive difficulty swallowing ever since. He complains that in addition to his difficulty swallowing, very cold or hot food and drink irritates his throat. There are no external signs of a lump on examination. He has also had earache intermittently for around the same length of time, but no tinnitus, dizziness, or discharge. The man weighed 80 kilograms 6 months ago, but is now 68 kilograms. He has smoked 20-30 cigarettes a day for the last 50 years. 

Given the likely diagnosis, what is the most likely abnormal histological finding?

Select the SINGLE most appropriate option from the list below. Select ONE option only.