Lymphocytic Esophagitis: A Histologic Pattern of Various Underlying Disorders

Area of Science:

• Gastroenterology
• Histopathology
• Esophageal Diseases

Background:

• Lymphocytic esophagitis (LyE) is a rare condition with inconsistent diagnostic criteria and clinical significance.
• Established clinical associations are lacking, with the exception of Crohn's disease in pediatric patients.

Purpose of the Study:

• To investigate if patients with LyE exhibit unique demographic or clinical characteristics compared to those with increased intraepithelial lymphocytes (IEL) in esophageal biopsies.

Main Methods:

• A retrospective review of esophageal biopsies from 2008 to 2023 was performed.
• Cases with increased IEL were identified, and their clinical, demographic, and endoscopic features were compared to LyE cases after excluding specific disorders.

Main Results:

• Out of 381 cases with increased IEL, 15 met the criteria for LyE.
• No distinct demographic, endoscopic, or associated morbidity differences were observed in LyE patients.
• A gradual increase in esophageal IEL did not correlate with demographic, endoscopic, or clinicopathologic variations.

Conclusions:

• Lymphocytic esophagitis appears to be a nonspecific histologic pattern associated with various esophageal disorders, rather than a distinct clinicopathologic entity.
• Future research should focus on identifying the underlying causes of this pattern instead of defining LyE as a singular entity.