Lymphocytic Esophagitis With XXXX T-cell-predominant Intraepithelial Lymphocytes and Primary Esophageal Motility Abnormalities: A Potential Novel Clinicopathologic Entity.

@entity1 @entity404 @entity2910 @entity1282 @entity4423 @entity405 @entity1319
UNASSIGNED: @entity2910 ( @entity2910 ) is an uncommon poorly defined histologic pattern. Its significance is largely unknown. The goal of our study was to characterize @entity2910 clinically, histologically, and immunophenotypically. Biopsies of 45 @entity1 with @entity2910 and no intraepithelial granulocytes were selected throughout a 36-month period during routine diagnostic work. After reevaluation, complete absence of intraepithelial granulocytes was confirmed in 21 @entity1 ( @entity2910 -NG group), and few granulocytes were found in 24 @entity1 ( @entity2910 -FG). The control group consisted of 28 @entity1 with @entity2910 consistent with reflux and overtly increased intraepithelial lymphocytes (REIL). The ratio of @entity404 : @entity405 intraepithelial lymphocytes (IEL)>1 indicated predominance of @entity404 IEL; the ratio  <=1 indicated predominance of @entity405 IEL. @entity1282 was the primary complaint in 71%, 54%, and 39% of the @entity1 with @entity2910 -NG, @entity2910 -FG, and REIL, respectively (P=0.04, @entity2910 -NG vs. REIL). Importantly, primary @entity4423 were found in 10/11 (91%) tested @entity2910 -NG @entity1 , 6/10 (60%) @entity2910 -FG @entity1 , and 6/11 (54%) REIL @entity1 . @entity404 IELs were predominant in 81%, 50%, and 39% of @entity2910 -NG, @entity2910 -FG, and REIL cases, respectively (P=0.004, @entity2910 -NG vs. REIL), and in 90%, 83%, and 88% of the cases with @entity1319 from the same groups. The prevalence of @entity1319 was significantly higher in @entity1 with @entity404 -predominant @entity2910 than in @entity1 with @entity405 -predominant @entity2910 from all groups (21/24 [83%] vs. 2/8 [25%], P=0.005). A distinctive type of @entity2910 with predominance of @entity404 IEL is associated with @entity1319 suggesting a diagnostic utility of evaluating @entity404 and @entity405 subpopulations of T cells in @entity2910 .
