From the Guidelines

The etiology of lymphocytic esophagitis is unknown, and its status as a distinct clinical entity is unclear.

The condition is characterized by a dense peripapillary lymphocytic infiltrate and peripapillary spongiosis involving the esophageal epithelium without significant eosinophilic or neutrophilic infiltrates 1.
Lymphocytic esophagitis (LyE) mostly affects women above the age of 60 1.
A primary symptom of dysphagia occurs in approximately two-thirds of patients with LyE 1.
Abnormal endoscopic findings, such as rings, esophagitis, and stricture, are described in approximately 70% to 75% of patients with LyE 1.

The diagnosis of lymphocytic esophagitis should occur after one rules out EoE-like disease through biopsies obtained off proton pump inhibitor therapy for at least 2–4 weeks and even Crohn’s disease, as these conditions may present in a similar manner histopathologically 1.
Lymphocytic esophageal recruitment seems to occur in response to a variety of scenarios where esophageal injury is taking place 1.

From the Research

Lymphocytic esophagitis (LE) is an esophageal condition characterized by an increased number of lymphocytes in the esophageal epithelium 2.
The etiology of LE is unclear, but studies suggest that it may be related to eosinophilic esophagitis (EoE) or a manifestation of gastroesophageal reflux disease (GERD) 2.
LE has also been associated with Crohn's disease in children, but not in adults 2, 3.
A study found that adult-onset lymphocyte-predominant esophagitis is also an immune-mediated inflammatory pattern, which may be masked by other conditions that feature esophageal lymphocytosis and occur in older patients 4.

Older age, female gender, and smoking history have been identified as potential risk factors for LE 5.
A study found that age older than 60, aspirin use, statin use, or a diagnosis of achalasia were associated with lymphocytic esophagitis 6.
Other potential risk factors that have been analyzed include IBD, achalasia, hyperlipidemia, hypothyroidism, celiac sprue, CVID, H. pylori, thymoma, opioids, ACE-I, and metformin use 6.
LE has also been associated with systemic immune-mediated disorders, particularly Crohn's disease and connective tissue diseases 4.

Patients with LE frequently report symptoms of dysphagia and GERD 2.
Treatment options for LE are limited and involve symptom management similar to treatment of EoE or GERD, including proton pump inhibitors (PPI), swallowed topical steroids, and endoscopic dilation 2.
A study found that lymphocytic esophagitis patients were more likely to respond to medical treatment compared to eosinophilic esophagitis patients 6.