Tonsillitis
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Tonsillitis is common and a reason the tonsils are removed (tonsillectomy). Malignancy is rare if not suspected; thus, tonsils can be considered a ditzel.
General
- Commonly removed (tonsillectomy) when enlarged.
- 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.[2]
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.
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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.