Difference between revisions of "Tonsillitis"

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#redirect [[Tonsillitis]]
'''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:

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

  1. 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.
  2. 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.
  3. 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.