Title: Clinical Profile of Asymmetric Tonsillar Enlargement
Authors: Parvathy A P, Sindhu V Nath, Satheesh Somaraj, Jayaprabha Sathyabhama, Venugopal M
DOI: https://dx.doi.org/10.18535/jmscr/v7i11.94
Abstract
Objective: Primary- To study the aetiology of asymmetric tonsillar enlargement.
Materials and Methods: This study was conducted over a period of 18 months (January 2017 – June 2018) and comprised of 54 patients of all age groups and either sex diagnosed as having asymmetric tonsillar enlargement and underwent either tonsillectomy or biopsy in the department of ENT, Government Medical College Hospital, Thiruvananthapuram. After obtaining consent for the study, detailed history taking and clinical examination were performed and other investigation reports were noted. Later the histopathology report of the operated specimen was obtained. All these results were analysed.
Results: Etiology was inferred from histopathological examination where 31(57.4%) of them were diagnosed with chronic tonsillitis. This was followed by 26% of squamous cell carcinoma. There were 4 cases of tonsillar cyst and 2 cases of Large B cell Non-Hodgkin‘s lymphoma. There was one case each of hamartomatous polyp, tonsillolith and clear cell carcinoma. The benign lesions together constituted 68.5% (37 cases) and 31.5% (17 cases) showed malignancy. Elderly males showed a significant association with the chance of developing malignancy.
Keyword: Asymmetric Tonsillar Enlargement.
References
- Ballin A, Koerner H, Ballin C, Pereira R, Alcantara L, et al. Palatine Tonsils Asymmetry: 10 Years Experience of the Otorhinolaryngology Service of the Clinical Hospital of the Federal University of Parana. Intl. Arch. Otorhinolaryngol. 2011;15(1):67-71
- Sumitha R, Mohamed H. Unilateral Tonsillar Enlargement – a case series. International Journal of Pharma and Bio Sciences 2013;4(4):(B) 472 – 477
- Sunkaraneni V, Jones S, Prasai A, Fish B. Is unilateral tonsillar enlargement alone an indication for tonsillectomy?. The Journal of Laryngology & Otology. 2006; E(21)
- Aringa ARD, Juares AJC, Melo C, Nardi JC, Kobari K, Filho R. Histological analysis of tonsillectomy and adenoidectomy specimens - January 2001 to May 2003. 2005; 71(1): 18-22
- Ikram M, Khan MA, Ahmed M, Siddiqui T, Mian MY. The histopathology of routine tonsillectomy specimens: results of a study and review of literature. Ear Nose Throat J 2000; 79(11): 880-2
- Mudra RK, Verma J, Gupta A, Koshta V, Rathore S. Tonsillar papilloma: a rare case. Inter J Med Sci Res Prac 2015; 2(3): 162-3
- Spinou C, Kubba H, Konstantinidis I, Johnston A. Role of tonsillectomy in histology for adults with unilateral tonsillar enlargement. Br J Oral Maxillofac Surg. 2005;43:144-7.
- Reiter ER, Randolph GW, Pilch BZ. Microscopic detection of occult malignancy in the adult tonsil. Otolaryngol Head Neck Surg. 1999;120:190–4
- Berkowitz RG, Mahadevan M. Unilateral tonsillar enlargement and tonsillar lymphoma in children. Ann Otol Rhinol Laryngol. 1999;108:876–9.
- Weibel E. Pathological findings of clinical value in tonsils and adenoids. Acta Otolaryngol (Stockh) 1965;60:331–338.
- Danielea L, Nikolarakosb D, Keenanb J, Schaeferb N, Lama AK. Clear cell carcinoma, not otherwise specified/ hyalinising clear cellcarcinoma of the salivary gland: The current nomenclature, clinical/pathological characteristics and management. Critical Reviews in Oncology/Hematology. 2016; 102:55–64.
- Burgess B, Ananthanarayanan V, Charous S. Hyalinizing Clear Cell Carcinoma of the Tonsil: A Case Report. Head and Neck Pathol 2017; 11:580–83
- Beaty M, Funk G, Karnell LH, Graham S, McCulloch T, Hoffman H, et al. Risk factors for malignancy in adult tonsils. Head and Neck. 1998;20:399-403
- Cinar F. Significance of asymptomatic tonsil asymmetry. Otolaryngol Head Neck Surg. 2004;131:101-3.
- Oluwasanmi A, Word A, Balwin D, Sipaul F. Malignancy in asymmetrical but otherwise normal palatine tonsils. Ear, Nose and Throat Journal. 2006;85:661-3.