A patient presents with aphthous ulcers on the tongue and buccal mucosa, linear white ulceration on the buccal mucosa, and cobblestone appearance of the oral mucosa. Biopsy would most likely show:

Correct answer: D. Granuloma (granulomatous inflammation)

• A. INCORRECT — Tzanck cells (acantholytic cells, balloon cells) are found in viral blistering diseases (herpes, pemphigus vulgaris), not in Crohn's disease.
• B. INCORRECT — Eosinophilic infiltrate is associated with eosinophilic ulcer (traumatic eosinophilic granuloma) or allergic reactions, not the described clinical picture.
• C. INCORRECT — A non-specific ulcer finding would not explain the cobblestone appearance and linear ulcerations, which are hallmarks of specific granulomatous disease.
• D. CORRECT — The cobblestone mucosa, linear ulcerations, and aphthous-like ulcers in the context of concurrent intestinal pathology strongly suggest CROHN'S DISEASE (orofacial granulomatosis). Biopsy of oral lesions in Crohn's disease reveals non-caseating granulomas, the histological hallmark.