Lymphocytic esophagitis mimicking eosinophilic esophagitis

A 74-year-old male with a history of dysphagia for 3 years presented with acute food impaction. Endoscopy showed a tight distal stricture with course rings at the middle third of the esophagus. Biopsies taken from the middle third of the esophagus showed marked infiltration of the intraepithelial lymphocytes mainly in a peripapillary distribution. The immunostains showed presence of CD3 and CD5 lymphocytes (T cell markers) in the epithelium. Lymphocytic esophagitis is a histologic phenotype of esophagitis diagnosed by marked esophageal lymphocytosis mostly in a peripapillary distribution with no or only rare intraepithelial granulocytes and presenting similar to eosinophilic esophagitis with dysphagia and esophageal rings.