A 46 year old man is being investigated for indigestion. Jejunal biopsy shows deposition of macrophages containing PAS (Periodic acid-schiff) +ve granules. What is the most likely diagnosis?

The key is D. Whipple’s disease. [periodic acid-schiff +ve granules containing macrophages in jejunal biopsy is diagnostic of whipples disease. Whipple disease is a systemic disease most likely caused by a gram-positive bacterium, Tropheryma whippelii. Although the first descriptions of the disorder described a malabsorption syndrome with small intestine involvement, the disease also affects the joints, central nervous system, and cardiovascular system].