Login Register Cart 0
Generic placeholder image

Recent Advances in Inflammation & Allergy Drug Discovery

Editor-in-Chief

ISSN (Print): 2772-2708
ISSN (Online): 2772-2716

Back
Journal Home About Journal Editorial Board Current Issue Volumes/Issues
Subscribe
Research Article

Lymphocytic Esophagitis: A Case Series of Esophageal Disease with Increasing Frequency

Author(s): Mohamad Yousef, Harleen Chela, Hamza Ertugrul, Abdulmajeed Albarrak, Omer Basar, Syed Pasha, Yousef Mousa, Alhareth Al Juboori, Shellaine Frazier, Veysel Tahan* and Ebubekir Daglilar

Volume 17, Issue 1, 2023

Published on: 03 February, 2023

Page: [79 - 84] Pages: 6

DOI: 10.2174/2772270817666230130093341

Price: $65

Abstract

Background: Lymphocytic esophagitis (LE) is a poorly understood clinical finding that has been increasingly identified in the last decade. Previous studies proposed increased frequency of LE in elderly females, as well as associations with smoking and pediatric Crohn’s disease.

Objective: We aimed to determine the patient characteristics and clinical features of our adult LE patients. As inflammation in the esophagus has been linked to cancer, this review also describes this association. However, there are no reported cases of malignant transformation in those with underlying lymphocytic esophagitis.

Methods: We retrospectively reviewed records for patients at the University of Missouri Hospital- Columbia (located in the USA) who had a histopathological diagnosis of LE. Cases of LE were identified using the pathology reporting system at the University of Missouri Hospital for esophageal biopsy specimens for the above-mentioned period.

Results: The data of a total of 20 adult cases with esophageal biopsy specimens consistent with LE were included.

Conclusion:LE seems to be a benign but disturbing clinical problem and should be remembered in elderly females complaining of dysphagia or refractory reflux symptoms. It has similar endoscopic findings of eosinophilic esophagitis with rings and esophagitis. Smoking and hiatal hernia are common risk factors. The majority of LE patients can respond to proton pump inhibitor (PPI) therapy. Endoscopic dilations and steroid therapy should be considered for PPI nonresponder LE patients.

« Previous
Graphical Abstract

[1]
Ismail-Beigi F, Horton PF, Pope CE II. Histological consequences of gastroesophageal reflux in man. Gastroenterology 1970; 58(2): 163-74.
[http://dx.doi.org/10.1016/S0016-5085(70)80004-X] [PMID: 5413015]
[2]
Rubio CA, Sjödahl K, Lagergren J. Lymphocytic esophagitis. Am J Clin Pathol 2006; 125(3): 432-7.
[http://dx.doi.org/10.1309/7LABLGY08UEM3H26] [PMID: 16613348]
[3]
Habbal M, Scaffidi MA, Rumman A, et al. Clinical, endoscopic, and histologic characteristics of lymphocytic esophagitis: a systematic review. Esophagus 2019; 16(2): 123-32.
[http://dx.doi.org/10.1007/s10388-018-0649-1] [PMID: 30370453]
[4]
Cohen S, Saxena A, Waljee AK, et al. Lymphocytic esophagitis. J Clin Gastroenterol 2012; 46(10): 828-32.
[http://dx.doi.org/10.1097/MCG.0b013e3182500de8] [PMID: 22751335]
[5]
Resnick MB, Finkelstein Y, Weissler A, Levy J, Yakirevich E. Assessment and diagnostic utility of the cytotoxic T-lymphocyte phenotype using the specific markers granzyme-B and TIA-1 in esophageal mucosal biopsies. Hum Pathol 1999; 30(4): 397-402.
[http://dx.doi.org/10.1016/S0046-8177(99)90114-4] [PMID: 10208460]
[6]
Kissiedu J, Thota PN, Gohel T, Lopez R, Gordon IO. Post-ablation lymphocytic esophagitis in Barrett esophagus with high grade dysplasia or intramucosal carcinoma. Mod Pathol 2016; 29(6): 599-606.
[http://dx.doi.org/10.1038/modpathol.2016.50] [PMID: 26965580]
[7]
Rouphael C, Gordon IO, Thota PN. Lymphocytic esophagitis: Still an enigma a decade later. World J Gastroenterol 2017; 23(6): 949-56.
[http://dx.doi.org/10.3748/wjg.v23.i6.949] [PMID: 28246468]
[8]
Straumann A, Bussmann C, Zuber M, Vannini S, Simon HU, Schoepfer A. Eosinophilic esophagitis: analysis of food impaction and perforation in 251 adolescent and adult patients. Clin Gastroenterol Hepatol 2008; 6(5): 598-600.
[http://dx.doi.org/10.1016/j.cgh.2008.02.003] [PMID: 18407800]
[9]
Ebach DR, Vanderheyden AD, Ellison JM, Jensen CS. Lymphocytic esophagitis: A possible manifestation of pediatric upper gastrointestinal Crohnʼs disease. Inflamm Bowel Dis 2011; 17(1): 45-9.
[http://dx.doi.org/10.1002/ibd.21347] [PMID: 20848529]
[10]
Purdy JK, Appelman HD, Golembeski CP, McKenna BJ. Lymphocytic esophagitis. Am J Clin Pathol 2008; 130(4): 508-13.
[http://dx.doi.org/10.1309/D3PCF6D6YYMQRX9A] [PMID: 18794041]
[11]
Patil DT, Hammer S, Langer R, Yantiss RK. Lymphocytic esophagitis: An update on histologic diagnosis, endoscopic findings, and natural history. Ann N Y Acad Sci 2018; 1434(1): 185-91.
[http://dx.doi.org/10.1111/nyas.13710] [PMID: 29797752]
[12]
Basseri B, Vasiliauskas EA, Chan O, et al. Evaluation of peripapillary lymphocytosis and lymphocytic esophagitis in adult inflammatory bowel disease. Gastroenterol Hepatol (N Y) 2013; 9(8): 505-11.
[PMID: 24719598]
[13]
Putra J, Muller KE, Hussain ZH, et al. Lymphocytic esophagitis in nonachalasia primary esophageal motility disorders. Am J Surg Pathol 2016; 40(12): 1679-85.
[http://dx.doi.org/10.1097/PAS.0000000000000712] [PMID: 27526295]
[14]
Pasricha S, Gupta A, Reed CC, Speck O, Woosley JT, Dellon ES. Lymphocytic esophagitis: An emerging clinicopathologic disease associated with dysphagia. Dig Dis Sci 2016; 61(10): 2935-41.
[http://dx.doi.org/10.1007/s10620-016-4230-2] [PMID: 27343035]
[15]
Vangimalla S, Gordon I, Thota PN. Lymphocytic esophagitis in common variable immune deficiency. Am J Gastroenterol 2016; 111(2): 170.
[http://dx.doi.org/10.1038/ajg.2015.178] [PMID: 26882931]
[16]
Niewiarowski TJ, Stoll LM. Recurrent dysphagia in a patient with chronic lymphocytic esophagitis. Gastrointest Endosc 2016; 84(6): 1071-2.
[http://dx.doi.org/10.1016/j.gie.2016.02.016] [PMID: 26902845]
[17]
Bonderup OK, Nielsen GL, Dall M, Pottegård A, Hallas J. Significant association between the use of different proton pump inhibitors and microscopic colitis: a nationwide Danish case-control study. Aliment Pharmacol Ther 2018; 48(6): 618-25.
[http://dx.doi.org/10.1111/apt.14916] [PMID: 30039564]
[18]
Paparoupa M, Linnemüller S, Schuppert F. Off-label use of Budesonide suspensions to treat a patient with lymphocytic esophagitis. Z Gastroenterol 2017; 55(11): 1127-30.
[PMID: 28787751]
[19]
Hendy PJ, Florin THJ, Florin TH. Spontaneous oesophageal perforation: An unreported complication of lymphocytic oesophagitis. Gut 2013; 62(11): 1668-9.
[http://dx.doi.org/10.1136/gutjnl-2013-305455] [PMID: 23850714]
[20]
Shipley LC, Al Momani LA, Locke A, Young M. Lymphocytic esophagitis: A rare disease on the rise. Cureus 2018; 10(2)e2153
[http://dx.doi.org/10.7759/cureus.2153] [PMID: 29637034]
[21]
Abdel-Latif MMM, Duggan S, Reynolds JV, Kelleher D. Inflammation and esophageal carcinogenesis. Curr Opin Pharmacol 2009; 9(4): 396-404.
[http://dx.doi.org/10.1016/j.coph.2009.06.010] [PMID: 19596608]
[22]
Hsu TC, Young MR, Cmarik J, Colburn NH. Activator protein 1 (AP-1– and nuclear factor κB (NF-κB)–dependent transcriptional events in carcinogenesis. Free Radic Biol Med 2000; 28(9): 1338-48.
[http://dx.doi.org/10.1016/S0891-5849(00)00220-3] [PMID: 10924853]
[23]
Cerutti PA, Trump BF. Inflammation and oxidative stress in carcinogenesis. Cancer Cells 1991; 3(1): 1-7.
[PMID: 2025490]
[24]
Herceg Z. Epigenetics and cancer: Towards an evaluation of the impact of environmental and dietary factors. Mutagenesis 2007; 22(2): 91-103.
[http://dx.doi.org/10.1093/mutage/gel068] [PMID: 17284773]
[25]
Coussens LM, Werb Z. Inflammation and cancer. Nature 2002; 420(6917): 860-7.
[http://dx.doi.org/10.1038/nature01322] [PMID: 12490959]

Rights & Permissions Print Cite
© 2024 Bentham Science Publishers | Privacy Policy