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DIS 5.4.0 DTD YGAST60909 proof 3 May 2017 5:03 pm ce 68 69 70 71 72 73 74 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 Question: A 64-year-old man presented with intermittent episodes of dysphagia to solids, which has been nonprogressive over the past 3 months. He denied any history of chest pain, vomiting, reflux symptoms, loss of appetite, or loss of weight. He is on treatment with 5 mg of amlodipine for hypertension and has had 3 episodes of transient ischemic attacks in past 2 years. For his neurologic symptoms, he has been extensively evaluated and is on treatment with 75 mg aspirin and 10 mg atorvastatin. 91 92 93 94 95 96 For dysphagia, he underwent multiple gastroscopies and biopsies of the esophagus which were reported as normal. His barium swallow showed indentations on the posterior wall of the esophagus (Figure A, white arrows). Contrast-enhanced magnetic resonance imaging of the neck confirmed the findings on barium swallow (Figure B, white arrows). What is your clinical diagnosis? Look on page 000 for the answer and see the Gastroenterology web site (www.gastrojournal.org) for more information on submitting your favorite image to Clinical Challenges and Images in GI. 97 98 99 100 Conflicts of interest The authors disclose no conflicts. 101 102 103 104 He was extensively evaluated for his neurologic symptoms and was treated with 75 mg aspirin and 10 mg atorvastatin.