Lymphocytic Esophagitis: Don’t Miss This
Lymphocytic Esophagitis: Don’t Miss This
Hello. I'm Dr. David Johnson, Professor of Medicine and Chief of Gastroenterology at Eastern Virginia Medical School.
Just when we thought that eosinophilic esophagitis (EoE) was a new entity, and even recognizing that it is still often being missed, here enters a new diagnosis, lymphocytic esophagitis. A couple of reports have just recently been published, and I'd like to share one in particular with you. The entity is not well known by gastroenterologists, and I don't think it is well known even by clinical pathologists. I want to bring you up to speed a little bit so that you can start being aware of it and potentially start looking for it.
What is lymphocytic esophagitis? It was described in 2006 by an investigator named Rubio. He found that it was a predominance of lymphocytic infiltration in the distal two thirds of the esophagus. He tried to associate it as an amalgamation of Crohn disease, but it has subsequently been refuted. It is not believed to be a manifestation of Crohn disease, and no other lymphocytic infiltration has been seen as people started looking into the duodenum and gastric biopsies, as we do with EoE when trying to rule out eosinophilic gastroenteritis.
An excellent attempt to put some clinical pathologic dialogue behind this was made by Genta and colleagues at the University of Texas Southwestern. They looked at a huge number of biopsies -- 140,000 biopsies -- in the esophagus. They tried to ascertain what the relative prevalence of lymphocytic esophagitis was and what some clinical correlations were. It set the stage for the most recent paper that was just published in Gastrointestinal Endoscopy by Tanaka and colleagues. Let me talk about these in sequence.
What Is This New Entity?
Hello. I'm Dr. David Johnson, Professor of Medicine and Chief of Gastroenterology at Eastern Virginia Medical School.
Just when we thought that eosinophilic esophagitis (EoE) was a new entity, and even recognizing that it is still often being missed, here enters a new diagnosis, lymphocytic esophagitis. A couple of reports have just recently been published, and I'd like to share one in particular with you. The entity is not well known by gastroenterologists, and I don't think it is well known even by clinical pathologists. I want to bring you up to speed a little bit so that you can start being aware of it and potentially start looking for it.
What is lymphocytic esophagitis? It was described in 2006 by an investigator named Rubio. He found that it was a predominance of lymphocytic infiltration in the distal two thirds of the esophagus. He tried to associate it as an amalgamation of Crohn disease, but it has subsequently been refuted. It is not believed to be a manifestation of Crohn disease, and no other lymphocytic infiltration has been seen as people started looking into the duodenum and gastric biopsies, as we do with EoE when trying to rule out eosinophilic gastroenteritis.
An excellent attempt to put some clinical pathologic dialogue behind this was made by Genta and colleagues at the University of Texas Southwestern. They looked at a huge number of biopsies -- 140,000 biopsies -- in the esophagus. They tried to ascertain what the relative prevalence of lymphocytic esophagitis was and what some clinical correlations were. It set the stage for the most recent paper that was just published in Gastrointestinal Endoscopy by Tanaka and colleagues. Let me talk about these in sequence.
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