Rubio Carlos A, Sjödahl Krister, Lagergren Jesper
Department of Pathology, Karolinska University Hospital and Institute, Stockholm, Sweden.
Am J Clin Pathol. 2006 Mar;125(3):432-7.
A novel histologic phenotype of chronic esophagitis, ie, lymphocytic esophagitis, is reported in 20 patients. Lymphocytic esophagitis is characterized by high numbers of intraepithelial lymphocytes (IELs) gathered mainly around peripapillary fields and by none (n = 12) to occasional (n = 8) CD15+ intraepithelial granulocytes. IELs expressed CD3, CD4 (42%), CD8 (36%), and granzyme B (0.2%), whereas T-cell intracytoplasmic antigen (TIA) 1 was not expressed. Of the 20 patients, 11 (55%) were 17 years or younger. Of 20 patients, 5 had no symptoms in the upper gastrointestinal tract. Only 4 (20%) of 20 patients had symptoms of gastroesophageal reflux disease and 6 (30%) of gastroduodenitis; 2 (10%) had celiac disease; 4 (20%) had carcinoma of the esophagus (1) or elsewhere (3); 1 (5%) each had hiatus hernia, gastric ulcer/asthma/blood hypertension, Hashimoto thyroiditis, and cirrhosis/diabetes; and 8 (40%) had Crohn disease. Hence, a novel histologic phenotype of chronic esophagitis called lymphocytic esophagitis is reported. Because phenotype is defined as the visible features resulting from the interaction between the genetic makeup and the environment, it is suggested that those factors might have a decisive role in the development of lymphocytic esophagitis.
本文报告了20例慢性食管炎的一种新组织学表型，即淋巴细胞性食管炎。淋巴细胞性食管炎的特征是大量上皮内淋巴细胞（IEL）主要聚集在乳头周围区域，且无（n = 12）至偶见（n = 8）CD15 +上皮内粒细胞。IEL表达CD3、CD4（42%）、CD8（36%）和颗粒酶B（0.2%），而T细胞胞浆内抗原（TIA）1未表达。20例患者中，11例（55%）年龄在17岁及以下。20例患者中，5例上消化道无症状。20例患者中仅4例（20%）有胃食管反流病症状，6例（30%）有胃十二指肠炎症；2例（10%）有乳糜泻；4例（20%）有食管癌（1例）或其他部位癌症（3例）；各有1例（5%）患食管裂孔疝、胃溃疡/哮喘/高血压、桥本甲状腺炎和肝硬化/糖尿病；8例（40%）有克罗恩病。因此，本文报告了一种称为淋巴细胞性食管炎的慢性食管炎新组织学表型。由于表型被定义为基因组成与环境相互作用产生的可见特征，因此提示这些因素可能在淋巴细胞性食管炎的发生中起决定性作用。
