Jideh Bilel, Keegan Andrew, Weltman Martin
Bilel Jideh, Andrew Keegan, Martin Weltman, Department of Gastroenterology and Hepatology, Nepean Hospital, New South Wales, Sydney 2747, Australia.
World J Clin Cases. 2016 Dec 16;4(12):413-418. doi: 10.12998/wjcc.v4.i12.413.
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.
淋巴细胞性食管炎（LyE）是一种罕见疾病，其组织学特征为食管上皮内淋巴细胞数量众多，无明显粒细胞浸润，伴有细胞间水肿（“海绵形成”）。尽管据报道吞咽困难是最常见症状，但LyE的临床意义和自然病程尚不明确。内镜特征范围从看似正常的食管黏膜到与嗜酸性粒细胞性食管炎相似的特征，包括食管环、线性沟、白色渗出物以及食管狭窄/狭窄。有症状的胃食管反流病与之关联并不一致。LyE与儿童克罗恩病有关，最近还与成人原发性食管动力障碍有关。尚无评估LyE有效治疗策略的研究；经验性治疗包括使用质子泵抑制剂和皮质类固醇。食管扩张已用于处理食管狭窄。据报道LyE病程呈良性；然而，曾有1例与LyE相关的食管穿孔病例。在此，我们描述3例淋巴细胞性食管炎患者的临床、内镜和组织病理学特征，并对当前文献进行综述。
