HISTOPATHOLOGICAL ANALYSIS OF TONSILLECTOMY SPECIMENS IN OUR HOSPITAL - A RETROSPECTIVE STUDY

P. J. SUDHAKAR; MULLAPUDY HARINI; GANDUPALLI YUGANDHAR

doi:10.22159/ajpcr.2022.v15i5.44189

Authors

P. J. SUDHAKAR Department of ENT, GITAM Institute of Medical Sciences and Research, GITAM Deemed to be University, Visakhapatnam, Andhra Pradesh, India. https://orcid.org/0000-0001-8648-1906
MULLAPUDY HARINI Department of ENT, GITAM Institute of Medical Sciences and Research, GITAM Deemed to be University, Visakhapatnam, Andhra Pradesh, India. https://orcid.org/0000-0001-8648-1906
GANDUPALLI YUGANDHAR Department of ENT, GITAM Institute of Medical Sciences and Research, GITAM Deemed to be University, Visakhapatnam, Andhra Pradesh, India.

DOI:

https://doi.org/10.22159/ajpcr.2022.v15i5.44189

Keywords:

Chronic tonsillitis, Tonsillectomy, Histopathology

Abstract

Objectives: Tonsillectomy is a frequently performed surgical procedure in ENT. Routine histopathological examinations (HPE) of the dissected tonsillar tissue are a gray area with no formal consensus among most of the otolaryngologists. The accidental discovery of underlying malignancy in the tonsillar specimens among the vulnerable group adds to the conundrum of whether is it mandatory to examine all tonsillar tissue. In this study, we retrospectively analyzed histopathological reports of tonsillar tissue dissected under the specific indication of chronic tonsillitis and documented the major histological features in chronic tonsillitis.

Methods: One hundred patient’s tonsillar specimens were retrospectively studied and analyzed and the major histopathological features are documented. The majority of patients were in the 11–20 years age group (45%). A slight male predominance (51%) was seen over females (49%).

Results: All the specimens were subjected to HPE and were demonstrated reactive lymphoid hyperplasia in all cases (100%), among others changes are surface ulcerations (45%) and bacterial colonies (40%) contributed to the other major histopathological findings. Significantly none of the one hundred tonsils have demonstrated the presence of metaplasia or neoplasia.

Conclusions: A tetrad of histopathological findings constitutes chronic tonsillitis with reactive lymphoid hyperplasia seen in all tonsillectomy specimens. No tonsillectomy specimen was demonstrated any underlying malignancy. Still, as a policy, it is better to check these specimens for any underlying neoplastic changes in the light of increasing chewing of tobacco-related products.

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References

Bluestone CD. Current indications for tonsillectomy and adenoidectomy. Ann Otol Rhinol Laryngol Suppl 1992;101:58-64. doi: 10.1177/00034894921010S112, PMID [CrossRef], Google Scholar

Mogoantă CA, Ioniţă E, Pirici D, Mitroi M, Anghelina FL, Ciolofan S, et al. chronic tonsillitis: Histological and immunohistochemical aspects. Rom J Morphol Embryol 2008;49:381-6. PMID 18758644

Singh I. Lymphatics and Lymphatic Tissue Textbook of Human Histology. 4th ed. India: Jaypee Brothers Medical Publishers; 2002. p. 191.

Hoddeson EK, Gourin CG. Adult tonsillectomy: Current indications and outcomesOtolaryngol. Otolaryngol Head Neck Surg 2009;140:19-22. doi: 10.1016/j.otohns.2008.09.023, PMID 19130955

Randel A. AAO-HNS guidelines for tonsillectomy in children and adolescents. Am Fam Physician 2011;84:566-73. PMID 21888309

Baugh RF, Archer SM, Mitchell RB, Rosenfeld RM, Amin R, Burns JJ, et al. Clinical practice guideline: Tonsillectomy in children. Otolaryngol Head Neck Surg 2011;144;1-30. doi: 10.1177/0194599810389949, PMID [CrossRef], Google Scholar

Smith MM, Peterson E, Yaremchuk KL. The role of tonsillectomy in adults with tonsillar hypertrophy and obstructive sleep apnea. Otolaryngol Head Neck Surg 2017;157:331-5. doi: 10.1177/0194599817698671, PMID [CrossRef], Google Scholar

Zhang PC, Pang YT, Loh KS, Wang DY. Comparison of histology between recurrent tonsillitis and tonsillar hypertrophy. Clin Otolaryngol Allied Sci 2003;28:235-9. doi: 10.1046/j.1365-2273.2003.00697.x, PMID 12755763

Felix F, Gomes GA, de Souza BP, Cardoso GA, Tomita S. Evaluation of the utility of histopathologic examination as a routine in tonsillectomies. Rev Bras Otorrinolaringol 2006;72:252-5.

Strong EB, Rubinstein B, Senders CW. Pathologic analysis of routine tonsillectomy and adenoidectomy specimens. Otolaryngol Head Neck Surg 2001;125:473-7. doi: 10.1067/mhn.2001.119862, PMID [CrossRef], Google Scholar

Ugras S, Kutluhan A. Chronic tonsillitis can be diagnosed with histopathologic findings. Eur J Gen Med 2008;5:95-103.

Hiari MA. Histopathology of the tonsil-is it important. Bahrain Med Bull 1999;21:58-9.

Williams MD, Brown HM. The adequacy of gross pathological examination of routine tonsils and adenoids in patients 21 years old and younger. Hum Pathol 2003;34:1053-7. doi: 10.1053/S0046- 8177(03)00408-8, PMID [CrossRef], Google Scholar

Alvi A, Vartanian AJ. Microscopic examination of routine tonsillectomy specimens: Is it necessary? Otolaryngol Head Neck Surg 1998;119:361-3. doi: 10.1016/S0194-5998(98)70079-8, PMID 9781991

Ikram M, Khan MA, Ahmed M, Siddiqui T, Mian MY. The histopathology of routine tonsillectomy specimens: Results of a study and review of the literature. Ear Nose Throat J 2000;79:880-2. doi: 10.1177/014556130007901110, PMID 11107690

Younis RT, Hesse SV, Anand VK. Evaluation of the utility and cost-effectiveness of obtaining histopathologic diagnosis on all routine tonsillectomy specimens. Laryngoscope 2001;111:2166-9. doi: 10.1097/00005537-200112000-00017, PMID [CrossRef], Google Scholar

Kepekçi AH, Balıkçı HH. Is routine histopathologic examination necessary following tonsillectomy and/or adenoidectomy procedures in pediatric patients? J Craniofac Surg 2017;28:91-3. doi: 10.1097/ SCS.0000000000003278, PMID [CrossRef], Google Scholar