Comparison of clinical and histopathological evaluation of tonsils in pediatric and adult patients

Abstract

The aim of this study was to determine clinical features that could predict the presence of tonsillar malignancy in children and adults. A retrospective review of the histopathologic reports of the children, who underwent tonsillectomy (753 cases) during the past 16 years (January 1991-December 2006) in a busy district general hospital, was undertaken. We compared the results to the pre-operative data of the patients, for risk factors of malignancy. Such proposed risk factors were tonsillar asymmetry, palpable firmness, visible lesions, neck adenopathy, history of malignancy, and systemic symptoms. The same data (history, risk factors and histopathologic results) were reviewed for an adult group (>16 years old, 1,027 cases) who underwent tonsillectomy during that period, and the results of the two groups were compared. In the pediatric group only one case was diagnosed as lymphoma (0.13%) and the rest as chronic inflammation (47%), reactive tonsil tissue (26%), lymphoid hyperplasia (19%) and actinomycosis (8%). In the lymphoma case, the diagnosis was suspected preoperatively by history and clinical manifestations. In the adult group, there were 21 cases of malignancy out of 1,027 cases (2.04%), again with one or more positive risk factors in the pre-surgery history. Based on our review, it is concluded that histopathology of tonsillectomy is not necessary in children unless there is clinical suspicion based on preoperative findings. A protocol based on proposed risk factors which may be predictive of possible malignancy can be used as a guide to intraoperative histology.

A Comparative Clinicopathologic Analysis of Tonsillectomy and Adenoidectomy Cases: A Retrospective Study

“…Among 288 patients, 129 were male and 159 were female. Most of the patients were younger than 18 years (mean age 12.55 ± 15.87 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]) and most of these patients have undergone an adenotonsillectomy. The mean age of adult patients was 38.79 ± 18.68 .…”

A Case of Primary Syphilis Masquerading as Tonsil Carcinoma

“…The majority of unilateral tonsillar enlargement is due to chronic inflammation, Actinomycoses sp. infection or lymphoid hyperplasia [6]. However, non-epithelial malignancies may present with unilateral tonsillar enlargement, the most common of which is lymphoma [7], furthermore systemic infections such as TB [8] and in this case, syphilis should also be a consideration.…”

Histopathological examination of tonsillectomy specimens: Some discussions

“…This can skew their study results because the differences of the diseases between the two age groups. [5,7] It is, therefore, interesting for the Adoga et al's [1] study to separate the histopathological results between the age groups. [3] Tonsillar malignancy is extremely rare in growing patients, but seems to be more common in adult patients.…”