Published online Feb 14, 2017. doi: 10.3748/wjg.v23.i6.949
Peer-review started: October 27, 2016
First decision: December 2, 2016
Revised: December 14, 2016
Accepted: January 18, 2017
Article in press: January 18, 2017
Published online: February 14, 2017
Lymphocytic esophagitis (LE) is a clinicopathologic entity first described by Rubio et al in 2006. It is defined as peripapillary intraepithelial lymphocytosis with spongiosis and few or no granulocytes on esophageal biopsy. This definition is not widely accepted and the number of lymphocytes needed to make the diagnosis varied in different studies. Multiple studies have described potential clinical associations and risk factors for LE, such as old age, female gender and smoking history. This entity was reported in inflammatory bowel disease in the pediatric population but not in adults. Other associations include gastroesophageal reflux disease and primary esophageal motility disorders. The most common symptom is dysphagia, with a normal appearing esophagus on endoscopy, though esophageal rings, webs, nodularities, furrows and strictures have been described. Multiple treatment modalities have been used such as proton pump inhibitors and topical steroids. Esophageal dilation seems to be therapeutic when dysphagia is present along with esophageal narrowing secondary to webs, rings or strictures. The natural history of the disease remains unclear and needs to be better delineated. Overall, lymphocytic esophagitis seems to have a chronic and benign course, except for two cases of esophageal perforation in the literature, thought to be secondary to this entity.
Core tip: Lymphocytic esophagitis has recently been described in 2006 and subsequently, multiple groups have attempted to describe its clinical associations and risk factors with minimal information available on treatment. We performed a PubMed search of all case reports and retrospective studies published in English about lymphocytic esophagitis. The objective of this paper is to present a scientific review of all aspects of this emerging clinical entity known to date.