Tonsillitis

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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.