El Halabi Maan, Saoud Carla, Nasser Selim M
Tufts Medical Center, Boston, MA.
School of Medicine, Lebanese American University.
J Clin Gastroenterol. 2025 Aug 1;59(7):626-628. doi: 10.1097/MCG.0000000000002067.
Lymphocytic esophagitis (LyE) is a rare condition that has been reported in several case studies, but its diagnostic criteria and clinical significance are inconsistent. There are no established clinical associations, except for Crohn's disease in children. Our study aimed to determine if patients with LyE have distinct demographic or clinical characteristics when compared with patients with increased intraepithelial lymphocytes (IEL) in their esophageal biopsy.
We conducted a retrospective review of all esophageal biopsies between 2008 and 2023 in 2 medical centers. After excluding cases that met criteria for specific disorders, we identified all cases with increased IEL and compared their clinical, demographic, and endoscopic characteristics to those of LyE.
We identified 381 cases with increased IEL, of which 15 met the criteria for LyE. Patients diagnosed with LyE showed no distinctive demographic, endoscopic, or associated morbidities. The gradual increase in esophageal IEL was not associated with any differences in demographic, endoscopic, or clinicopathologic findings.
Our findings suggest that lymphocytic esophagitis is not a well-defined clinicopathologic entity but rather a rare and nonspecific histologic pattern associated with various esophageal disorders. Further studies should aim to differentiate between the underlying causes of this histologic pattern, rather than defining it as a single clinicopathologic entity.
淋巴细胞性食管炎（LyE）是一种罕见疾病，已有多项病例研究报道，但诊断标准和临床意义并不一致。除儿童克罗恩病外，尚无已确立的临床关联。我们的研究旨在确定与食管活检中上皮内淋巴细胞（IEL）增多的患者相比，LyE患者是否具有独特的人口统计学或临床特征。
我们对2家医疗中心2008年至2023年间的所有食管活检进行了回顾性研究。在排除符合特定疾病标准的病例后，我们确定了所有IEL增多的病例，并将其临床、人口统计学和内镜特征与LyE患者进行比较。
我们确定了381例IEL增多的病例，其中15例符合LyE标准。诊断为LyE的患者在人口统计学、内镜检查或相关疾病方面没有显著差异。食管IEL的逐渐增加与人口统计学、内镜检查或临床病理结果的任何差异均无关联。
我们的研究结果表明，淋巴细胞性食管炎不是一个明确的临床病理实体，而是一种与各种食管疾病相关的罕见且非特异性的组织学模式。进一步的研究应旨在区分这种组织学模式的潜在原因，而不是将其定义为单一的临床病理实体。
