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Rings and trachealisation are usually described in eosinophilic oesophagitis, but they are uncommonly reported in LyE. A 79-year-old woman developed progressive dysphagia and weight loss; endoscopy showed oesophageal trachealisation and histology confirmed florid lymphocytic oesophagitis. Partial PPI response occurred, while swallowed budesonide induced marked improvement with weight stabilisation.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/trachealisation-of-the-oesophagus-in-lymphocytic-oesophagitis-an-uncommon-endoscopic-presentation/432364/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/trachealisation-of-the-oesophagus-in-lymphocytic-oesophagitis-an-uncommon-endoscopic-presentation/432364.png","ImageObject",300,407,{"name":92,"@type":93},"Marglet","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-31","2026-09-29",true,{"@type":102,"interactionType":103,"userInteractionCount":34},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is lymphocytic oesophagitis (LyE) and how is it diagnosed?","Question",{"text":112,"@type":113},"LyE is a rare chronic oesophagitis subtype diagnosed histologically by increased peripapillary intraepithelial lymphocytes with absent or minimal eosinophils or neutrophils. Endoscopic appearances can be variable and may look normal despite diagnostic histology, making biopsy essential.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Why is oesophageal trachealisation notable in this case?",{"text":117,"@type":113},"Trachealisation is typically associated with eosinophilic oesophagitis, while it is uncommonly described in LyE. This case reports trachealisation as an unusual endoscopic manifestation, expanding the recognised phenotypic spectrum of LyE.",{"name":119,"@type":110,"acceptedAnswer":120},"How did the patient respond to treatment?",{"text":121,"@type":113},"The patient had only partial symptom relief with proton pump inhibitor (PPI) therapy. After induction with swallowed budesonide, she experienced marked clinical improvement and weight stabilisation.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},432364,1791099604,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":34,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":24,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144,"preview_page_count":4},2336477982702,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","Review began 11/11/2025  \nReview ended 11/30/2025  \nPublished 12/05/2025  \n© Copyright 2025  \nMohamed Maheen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98507  \nOpen Access Case Report  \nTrachealisation of the Oesophagus in Lymphocytic Oesophagitis: An Uncommon Endoscopic Presentation  \nMurshid Ali Mohamed Maheen 1, Kashif Hameed 1 , Mark R. Andrew 1  \n1. Gastroenterology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, GBR Corresponding author: Murshid Ali Mohamed Maheen, [murshidali.mohamedmaheen@gmail.com](murshidali.mohamedmaheen@gmail.com)  \nAbstract  \nLymphocytic oesophagitis (LyE) is a rare histopathological diagnosis with variable and often non-specific endoscopic features. Oesophageal rings and trachealisation are typically associated with eosinophilicoesophagitis but are uncommonly described in LyE. We describe a 79-year-old woman who presented with progressive dysphagia and unintentional weight loss. Endoscopic examination demonstrated trachealisation of the oesophagus, while histopathological evaluation confirmed florid lymphocytic oesophagitis with apoptotic keratinocytes. The patient exhibited only partial symptom relief with proton pump inhibitor (PPI) therapy; however, induction with swallowed budesonide resulted in marked clinical improvement and weight stabilisation. This case highlights an unusual endoscopic manifestation of LyE, expanding the recognised phenotypic spectrum of this entity and emphasising the essential role of histopathological evaluation in distinguishing oesophagitis subtypes.  \nCategories: Pathology, Gastroenterology  \nKeywords: budesonide, dysphagia, eosinophilic oesophagitis, lymphocytic oesophagitis, trachealisation  \nIntroduction  \nLymphocytic oesophagitis (LyE) is a rare subtype of chronic oesophagitis, [first described by Rubio et al. in](first described by Rubio et al. in)[ ](first described by Rubio et al. in)[2006](2006) [1] . It remains an uncommon diagnosis, with population-based studies estimating a prevalence of approximately 0.1-0.2% of all oesophageal biopsies, although higher rates of up to 8-12% have been reported in selected cohorts evaluated for dysphagia [2,3] . It is characterised by a distinct histologic pattern of increased peripapillary intraepithelial lymphocytes with absent or minimal intraepithelial granulocytes. Clinically, LyE presents with variable symptoms, including dysphagia, dyspepsia, nausea, and non-cardiac chest pain [2] . The condition is reported most frequently in middle-aged to older women and has been associated with tobacco use, gastro-oesophageal reflux disease (GERD), and, in some cases, oesophageal motility disorders [2,3] .  \nHistologically, diagnosis depends on identifying peripapillary intraepithelial lymphocytosis, marked intercellular oedema (spongiosis), and minimal or absent eosinophils or neutrophils. Although no universal cut-off exists, a practical threshold of more than 20 intraepithelial lymphocytes per high-power field in the absence of infection is often applied [3] . Endoscopic findings are variable and may range from a normalappearing oesophagus to mucosal fragility, linear furrows, rings, strictures, white plaques, or oedema. In many cases, the mucosa appears macroscopically normal despite diagnostic histology [2,3] . Because LyE and eosinophilic oesophagitis (EoE) share overlapping clinical symptoms, particularly dysphagia and chest discomfort, and may both exhibit features such as rings, linear furrows, or oedema, the two conditions are frequently confused clinically and endoscopically. However, unlike EoE, LyE lacks a prominent eosinophilic infiltrate, making histology essential for accurate distinction [3,4] .  \nThe pathogenesis ofLyE remains incompletely understood. Propose","cbCaicBoKS34bncx","https://ap.wps.com/l/cbCaicBoKS34bncx","pdf",2555555,"English","# Abstract\n# Introduction\n# Case Presentation","[{\"question\":\"What is lymphocytic oesophagitis (LyE) and how is it diagnosed?\",\"answer\":\"LyE is a rare chronic oesophagitis subtype diagnosed histologically by increased peripapillary intraepithelial lymphocytes with absent or minimal eosinophils or neutrophils. Endoscopic appearances can be variable and may look normal despite diagnostic histology, making biopsy essential.\"},{\"question\":\"Why is oesophageal trachealisation notable in this case?\",\"answer\":\"Trachealisation is typically associated with eosinophilic oesophagitis, while it is uncommonly described in LyE. This case reports trachealisation as an unusual endoscopic manifestation, expanding the recognised phenotypic spectrum of LyE.\"},{\"question\":\"How did the patient respond to treatment?\",\"answer\":\"The patient had only partial symptom relief with proton pump inhibitor (PPI) therapy. After induction with swallowed budesonide, she experienced marked clinical improvement and weight stabilisation.\"}]","Trachealisation of the Oesophagus in Lymphocytic Oesophagitis - An Uncommon Endoscopic Presentation | PDF",1790659353,13]