Tonsillar Crypts and Bacterial Invasion of Tonsils: A Pilot Study

Abstract

Abstract:Objective: To investigate histologically if a lack of protection of the deep lymphoid tissue in tonsillar crypts by an intact epithelial covering is an aetiological factor for tonsillitis.Method: A prospective histological study of the tonsillar crypt epithelium by immunostaining for cytokeratin in 34 consecutive patients undergoing tonsillectomy either for tonsillitis or tonsillar hypertrophy without infection (17 patients in each group).Results: Discontinuity in the epithelium was found in 70.6% of the groups of patients with tonsillitis and in 35.3% of the groups of patients with tonsillar hypertrophy. This is of borderline significance. Conclusion:We found no clear correlation between tonsillitis and a defect in the tonsillar crypt epithelium. Tonsillitis might be due to immunological differences of subjects rather than a lack of integrity of the crypt epithelium. Further study with larger sample size and normal control is suggested.

Histological and Immunohistochemical Analysis of Special Compartments of Palatin Tonsils in Relation to Tonsillar Diseases

“…This indicated that the recognizable level of immune reactivity occurs more in crypt epithelium than in the surface epithelium, which explain by increasing number of HEVs in the crypt epithelium more than in surface epithelium (15). Mal et al, (2008) recommended that the major functions of the reticulated epithelium are to provide a favorable environment for the intimate contact between the effector cells of immune responses, to facilitate direct transport of antigens, to synthesise the secretory component continually and to contain a pool of immunoglobulins. Thus the reticulated epithelium lining the tonsillar crypts represents a specialised compartment, important in the immunological functions of the tonsil as a whole 16 .…”

“…Mal et al, (2008) recommended that the major functions of the reticulated epithelium are to provide a favorable environment for the intimate contact between the effector cells of immune responses, to facilitate direct transport of antigens, to synthesise the secretory component continually and to contain a pool of immunoglobulins. Thus the reticulated epithelium lining the tonsillar crypts represents a specialised compartment, important in the immunological functions of the tonsil as a whole 16 . In the current study the number of (HEVs) was significantly higher in recurrent tonsillitis compared to hypertrophied tonsils and chronic tonsilitis, roughly there is no previous study regarding the presence (HEVs) according to diseases of the tonsile but there is general agreement that the (HEVs) can play an important role in the pathogenesis of chronic inflammatory diseases since (HEVs) have been contributed in mechanism for increasing lymphocyte entry into the inflamed tissue, consequently participate in the maintain and amplification of chronic diseases 12,13,15 .…”