Published online Dec 16, 2016. doi: 10.12998/wjcc.v4.i12.413
Peer-review started: April 12, 2016
First decision: May 19, 2016
Revised: September 7, 2016
Accepted: September 21, 2016
Article in press: September 22, 2016
Published online: December 16, 2016
Lymphocytic esophagitis (LyE) is a rare condition characterised histologically by high numbers of esophageal intraepithelial lymphocytes without significant granulocytes infiltration, in addition to intercellular edema (“spongiosis”). The clinical significance and natural history of LyE is poorly defined although dysphagia is reportedly the most common symptom. Endoscopic features range from normal appearing esophageal mucosa to features similar to those seen in eosinophilic esophagitis, including esophageal rings, linear furrows, whitish exudates, and esophageal strictures/stenosis. Symptomatic gastroesophageal reflux disease is an inconsistent association. LyE has been associated in paediatric Crohn’s disease, and recently in primary esophageal dysmotility disorder in adults. There are no studies assessing effective treatment strategies for LyE; empirical therapies have included use of proton pump inhibitor and corticosteroids. Esophageal dilatation have been used to manage esophageal strictures. LyE has been reported to run a benign course; however there has been a case of esophageal perforation associated with LyE. Here, we describe the clinical, endoscopic and histopathological features of three patients with lymphocytic esophagitis along with a review of the current literature.
Core tip: Lymphocytic esophagitis (LyE) is a histological subset of esophagitis that is rare with poorly defined clinical significance and associations. We present the clinical, endoscopic and histopathological features of three patients with LyE followed by the most up-to-date literature on the condition, including description of the newly postulated association of primary esophageal dysmotility.