Purdy Julianne K, Appelman Henry D, Golembeski Christopher P, McKenna Barbara J
Department of Pathology, University of Michigan, Ann Arbor, MI 48109-0054, USA.
Am J Clin Pathol. 2008 Oct;130(4):508-13. doi: 10.1309/D3PCF6D6YYMQRX9A.
Lymphocytic esophagitis (LE) is characterized by intraepithelial lymphocytes (IELs) and spongiosis, resembling contact dermatitis. LE has been defined as high numbers of IELs and no or rare granulocytes and was found in young patients and in association with Crohn disease (CD). We reviewed the medical records of 42 LE cases. Cases were divided into severe (IELs in interpapillary and peripapillary fields) and mild (IELs in peripapillary fields) LE. The control group included specimens from 34 consecutive esophageal biopsy cases. Mean ages were similar (LE, 44 years; control subjects, 43 years). CD was present in 5 LE cases (12%) and 1 control case, an insignificant difference. Of patients with LE, 14 (33%) had an allergy; 11 (26%), gastroesophageal reflux disease (GERD); 4 (10%), Helicobacter pylori gastritis; and 18 (43%), dysphagia. No differences were found in clinical features between LE and control cases, except GERD was less common in severe LE (6/30 [20%]) than in control cases (17 [50%]). No patient with LE had celiac disease. No medications were common among LE cases. Patients with LE are statistically no more likely than control subjects to have CD. We found no association between LE and any clinical condition or symptom. Based on sequential biopsies in 7 patients, LE seems to be a chronic disease.
淋巴细胞性食管炎（LE）的特征为上皮内淋巴细胞（IELs）和海绵形成，类似接触性皮炎。LE被定义为IELs数量较多且无或仅有罕见粒细胞，多见于年轻患者，并与克罗恩病（CD）相关。我们回顾了42例LE病例的病历。病例分为重度（乳头间和乳头周围区域有IELs）和轻度（乳头周围区域有IELs）LE。对照组包括34例连续食管活检病例的标本。平均年龄相似（LE组44岁；对照组43岁）。5例LE病例（12%）和1例对照病例存在CD，差异无统计学意义。LE患者中，14例（33%）有过敏；11例（26%）有胃食管反流病（GERD）；4例（10%）有幽门螺杆菌胃炎；18例（43%）有吞咽困难。除GERD在重度LE中（6/30 [20%]）比对照组（17例 [50%]）少见外，LE与对照病例的临床特征无差异。LE患者均无乳糜泻。LE病例中无常见的用药情况。LE患者患CD的统计学可能性并不高于对照组。我们未发现LE与任何临床状况或症状之间存在关联。基于7例患者的序贯活检，LE似乎是一种慢性疾病。
