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Lymphocytic oesophagitis: pathologists and clinicians look out
Lymphocytic oesophagitis (LyE) has been reported in small series, but no consistent clinical correlations have emerged. In this issue of Gut, Haque and Genta (see page 1108) sought to determine the prevalence of LyE in a large US population and define its characteristics. Having established the criteria for the histopathological diagnosis of LyE (see figure 1), the authors then reviewed cases with this diagnosis, collected demographic, clinical and endoscopic data, and compared them with patients with either eosinophilic oesophagitis (EoE) or normal oesophageal biopsies. The study included 129 252 unique patients and controls. A diagnosis of LyE was made in 119 patients (median age 63 years, 40% men; 0.1% of patients with oesophageal biopsies). Dysphagia was as common in these patients as in those with EoE (53% vs 63%; NS), but gastro-oesophageal reflux disease was low in both (18% vs 19%, NS). The clinical and endoscopic characteristics of LyE and EoE overlap considerably although LyE affects predominantly older women. Although the precise clinical significance of oesophageal lymphocytic infiltrates remain to be defined, their association with dysphagia and possibly motility disorders warrants further investigations. More pathologists and clinicians should become aware of this entity and this will no doubt help uncover …
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