Difference between revisions of "Tonsillitis"
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'''Tonsillitis''' is common and a reason the [[tonsil]]s are removed (tonsillectomy). | |||
[[Malignancy]] in tonsils is rare if not suspected; thus, [[tonsil]]s can be considered a [[ditzel]]. | |||
==General== | |||
*Commonly removed (tonsillectomy) when enlarged. | |||
*''Tonsillitis'' is a [[clinical diagnosis]]. | |||
*Very low probability of malignancy (<0.2%) in tonsilectomies in individuals <19 years old if no clinical suspicion.<ref name=pmid15963574>{{Cite journal | last1 = Erdag | first1 = TK. | last2 = Ecevit | first2 = MC. | last3 = Guneri | first3 = EA. | last4 = Dogan | first4 = E. | last5 = Ikiz | first5 = AO. | last6 = Sutay | first6 = S. | title = Pathologic evaluation of routine tonsillectomy and adenoidectomy specimens in the pediatric population: is it really necessary? | journal = Int J Pediatr Otorhinolaryngol | volume = 69 | issue = 10 | pages = 1321-5 | month = Oct | year = 2005 | doi = 10.1016/j.ijporl.2005.05.005 | PMID = 15963574 }}</ref> | |||
==Gross== | |||
*Symmetrical and equal size. | |||
Note: | |||
*Gross exam is considered sufficient if there is no asymmetry if individual younger than 21 years of age.<ref name=pmid14608541>{{Cite journal | last1 = Williams | first1 = MD. | last2 = Brown | first2 = HM. | title = The adequacy of gross pathological examination of routine tonsils and adenoids in patients 21 years old and younger. | journal = Hum Pathol | volume = 34 | issue = 10 | pages = 1053-7 | month = Oct | year = 2003 | doi = | PMID = 14608541 }}</ref> | |||
===Image==== | |||
<gallery> | |||
Image:Tonsillectomy tonsils.JPEG|Tonsils at [[cut-up]]. ([[WC]]/Katotomichelakis ''et al.'') | |||
</gallery> | |||
==Microscopic== | |||
Features: | |||
*Follicular hyperplasia - see ''[[lymph node pathology]]''. | |||
*+/-Colonies (clusters) of [[actinomycetes]] in the tonsillar crypts. | |||
DDx: | |||
*Non-Hodgkin [[lymphoma]].<ref name=pmid20426908>{{Cite journal | last1 = Wang | first1 = XY. | last2 = Wu | first2 = N. | last3 = Zhu | first3 = Z. | last4 = Zhao | first4 = YF. | title = Computed tomography features of enlarged tonsils as a first symptom of non-Hodgkin's lymphoma. | journal = Chin J Cancer | volume = 29 | issue = 5 | pages = 556-60 | month = May | year = 2010 | doi = | PMID = 20426908 }}</ref> | |||
*Others - see ''[[tonsil]]''. | |||
==IHC== | |||
If there is a clinical suspicion - a panel to exclude (small cell) non-Hodgkin lymphomas: | |||
*CD3. | |||
*CD20. | |||
*CD5. | |||
*CD10. | |||
*CD23. | |||
*Cyclin D1. | |||
==Sign out== | |||
<pre> | |||
A. Tonsil, Left, Tonsillectomy: | |||
- Reactive follicular hyperplasia. | |||
- Reactive squamous mucosa. | |||
B. Tonsil, Right, Tonsillectomy: | |||
- Reactive follicular hyperplasia. | |||
- Reactive squamous mucosa. | |||
</pre> | |||
===Block letters=== | |||
<pre> | |||
A. TONSIL, LEFT, TONSILLECTOMY: | |||
- REACTIVE FOLLICULAR HYPERPLASIA. | |||
- REACTIVE SQUAMOUS MUCOSA. | |||
B. TONSIL, RIGHT, TONSILLECTOMY: | |||
- REACTIVE FOLLICULAR HYPERPLASIA. | |||
- REACTIVE SQUAMOUS MUCOSA. | |||
</pre> | |||
===Without squamous mucosa=== | |||
<pre> | |||
A. TONSIL, LEFT, TONSILLECTOMY: | |||
- REACTIVE FOLLICULAR HYPERPLASIA. | |||
B. TONSIL, RIGHT, TONSILLECTOMY: | |||
- REACTIVE FOLLICULAR HYPERPLASIA. | |||
</pre> | |||
==See also== | |||
*[[Tonsil]]. | |||
*[[Ditzels]]. | |||
==References== | |||
{{Reflist|1}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Ditzels]] | |||
Latest revision as of 14:24, 6 April 2016
Tonsillitis is common and a reason the tonsils are removed (tonsillectomy).
Malignancy in tonsils is rare if not suspected; thus, tonsils can be considered a ditzel.
General
- Commonly removed (tonsillectomy) when enlarged.
- Tonsillitis is a clinical diagnosis.
- Very low probability of malignancy (<0.2%) in tonsilectomies in individuals <19 years old if no clinical suspicion.[1]
Gross
- Symmetrical and equal size.
Note:
- Gross exam is considered sufficient if there is no asymmetry if individual younger than 21 years of age.[2]
Image=
Microscopic
Features:
- Follicular hyperplasia - see lymph node pathology.
- +/-Colonies (clusters) of actinomycetes in the tonsillar crypts.
DDx:
IHC
If there is a clinical suspicion - a panel to exclude (small cell) non-Hodgkin lymphomas:
- CD3.
- CD20.
- CD5.
- CD10.
- CD23.
- Cyclin D1.
Sign out
A. Tonsil, Left, Tonsillectomy: - Reactive follicular hyperplasia. - Reactive squamous mucosa. B. Tonsil, Right, Tonsillectomy: - Reactive follicular hyperplasia. - Reactive squamous mucosa.
Block letters
A. TONSIL, LEFT, TONSILLECTOMY: - REACTIVE FOLLICULAR HYPERPLASIA. - REACTIVE SQUAMOUS MUCOSA. B. TONSIL, RIGHT, TONSILLECTOMY: - REACTIVE FOLLICULAR HYPERPLASIA. - REACTIVE SQUAMOUS MUCOSA.
Without squamous mucosa
A. TONSIL, LEFT, TONSILLECTOMY: - REACTIVE FOLLICULAR HYPERPLASIA. B. TONSIL, RIGHT, TONSILLECTOMY: - REACTIVE FOLLICULAR HYPERPLASIA.
See also
References
- ↑ Erdag, TK.; Ecevit, MC.; Guneri, EA.; Dogan, E.; Ikiz, AO.; Sutay, S. (Oct 2005). "Pathologic evaluation of routine tonsillectomy and adenoidectomy specimens in the pediatric population: is it really necessary?". Int J Pediatr Otorhinolaryngol 69 (10): 1321-5. doi:10.1016/j.ijporl.2005.05.005. PMID 15963574.
- ↑ Williams, MD.; Brown, HM. (Oct 2003). "The adequacy of gross pathological examination of routine tonsils and adenoids in patients 21 years old and younger.". Hum Pathol 34 (10): 1053-7. PMID 14608541.
- ↑ Wang, XY.; Wu, N.; Zhu, Z.; Zhao, YF. (May 2010). "Computed tomography features of enlarged tonsils as a first symptom of non-Hodgkin's lymphoma.". Chin J Cancer 29 (5): 556-60. PMID 20426908.