| A clinicopathologic series of 22 cases of tonsillar granulomas. | |
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MedLine Citation:
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PMID: 10718441 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Tonsils are uncommonly affected by granulomatous inflammation, often with an obscure cause. This study attempts to elucidate the nature of tonsillar granulomatous inflammation. DESIGN: Retrospective clinicopathologic review. METHODS: Twenty-two cases of tonsillar granulomas diagnosed between 1940 and 1999 were retrieved from the files of the Armed Forces Institute of Pathology. H&E slides and a series of histochemical stains were reviewed, and patient follow-up was obtained. RESULTS: There were 11 males and 11 females, aged 7 to 64 years (mean, 29.9 y). Most of the cases presented bilaterally (n = 19) with sore throat, dysphagia, and/or nasal obstruction. The clinical differential included chronic tonsillitis, tuberculosis, nonspecific infection, sarcoidosis, and a neoplasm. Histologically, the granulomas were focal and scattered, or diffuse, identified in the interfollicular zones (n = 16) and/or the germinal centers (n = 13), and occasionally associated with necrosis (n = 6). Based on histochemical and clinical follow-up information, the etiology of the granulomas included sarcoidosis (n = 8), tuberculosis (n = 3), Hodgkin's lymphoma (n = 2), toxoplasmosis (n = 1), squamous cell carcinoma (n = 1), and no specific known cause (n = 7). Twelve patients were either alive at last follow-up or had died with no evidence of disease (mean, 12.4 y), and 9 were either alive at last follow-up or had died with disease (mean, 24.9 y). One patient was alive with unknown disease status (lost to follow-up after 13.3 y). CONCLUSIONS: Although a cause for tonsillar granulomas is frequently identified, a number may not develop an identifiable etiology, with the granulomas probably representing an exaggerated immune response to chronic tonsillitis. However, a careful work-up must be conducted to exclude specific causes and avoid clinical mismanagement. |
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Authors:
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D E Kardon; L D Thompson |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: The Laryngoscope Volume: 110 ISSN: 0023-852X ISO Abbreviation: Laryngoscope Publication Date: 2000 Mar |
Date Detail:
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Created Date: 2000-03-30 Completed Date: 2000-03-30 Revised Date: 2005-11-17 |
Medline Journal Info:
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Nlm Unique ID: 8607378 Medline TA: Laryngoscope Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 476-81 Citation Subset: IM |
Affiliation:
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Department of Endocrine and Otorhinolaryngic-Head and Neck Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Carcinoma, Squamous Cell / diagnosis Child Chronic Disease Coloring Agents / diagnostic use Deglutition Disorders / etiology Diagnosis, Differential Disease-Free Survival Female Fluorescent Dyes / diagnostic use Follow-Up Studies Granuloma / complications, diagnosis*, parasitology, pathology Hodgkin Disease / diagnosis Humans Male Middle Aged Nasal Obstruction / etiology Pharyngitis / etiology Retrospective Studies Sarcoidosis / diagnosis Survival Rate Tonsillitis / complications, diagnosis*, parasitology, pathology Toxoplasmosis / diagnosis Tuberculosis, Lymph Node / diagnosis |
| Chemical | |
Reg. No./Substance:
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0/Coloring Agents; 0/Fluorescent Dyes |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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