This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Zollinger Ellision Syndrome, Subject name: Medicine
Pseudoachalasia is seen with all except? 
Select and explain. 
A. Esophageal tumor, B. Paraneoplastic, C. Carcinoma fundus, D. Rosary esophagus
D: Rosary esophagus
Answer: D: Rosary esophagus 
Explanation: Causes of pseudo-achalasia 1. Tumor infiltration, most commonly seen with carcinoma in the gastric fundus or distal esophagus can mimic idiopathic achalasia. 2. Rarely, pseudo achalasia can result from a paraneoplastic syndrome with circulating antineuronal antibodies * Pseudoachalasia presents at young age, abrupt onset of symptoms (year), and weight loss. Hence, endoscopy should be pa of the evaluation of achalasia. * When the clinical suspicion for pseudoachalasia is high and endoscopy nondiagnostic, CT scanning or endoscopic ultrasonography may be of value. * Since barium swallow may not be able to differentiate achalasia from pseudoachalasia, (MRI and CT scan must be done for determining the cause as well as for staging. Radiographically, a "corkscrew esophagus," rosary bead esophagus," is indicative of diffuse esophageal spasm.