Clinical and histopathological correlation in patients with chronic tonsillitis


  • Sanjana V. Nemade Department of Otorhinolaryngology, Smt Kashibai Navale Medical College, Narhe, Pune, Maharashtra, India
  • Lakshmikant B. Yadav Department of Otorhinolaryngology, Smt Kashibai Navale Medical College, Narhe, Pune, Maharashtra, India



Germinal centre, Tonsil hypertrophy, Lymphoid tissue


Background: Chronic tonsillitis is diagnosed when an individual has 7 episodes of tonsillitis in 1 year, 5 episodes in 2 consecutive years, or 3 episodes each year for 3 years consecutively. There is correlation of clinical and histopathological findings in patients with chronic tonsillitis.

Methods: It is prospective study which is aimed at correlation of clinical and histopathological findings in chronic tonsillitis patients underwent tonsillectomy. This was carried out in tertiary care hospital, Pune, Maharashtra, India. In our study, 25 patients of chronic tonsillitis underwent tonsillectomy were included. In this we have examined the histopathology of tonsillar tissue section in correlation with the clinical manifestations of tonsillar diseases that were due to infection.  

Results: In pathological examination of palatine tonsil, underlying subepithelial tissue showed many lymphoid follicles with prominent germinal centres comprising of centrocytes, centroblasts, immunoblasts, small and large lymphocytes in 19 patients (76%). 13 patients (52%) showed prominent germinal centres with bites of salivary gland and muscle tissue. 6 patients (24%) showed prominent germinal centre with mild lymphoplasmocytic inflammatory cell infiltrate. In 4 patients (16%), tissue lined by stratified squamous epithelium showed focal ulceration. 3 patients (12%) showed stratified squamous epithelium with granulation tissue. Crush artifact were noted in 3 patients (12%). 2 patients (8%) had small granules with actinomycotic species colonies within the palatine tonsilar crypts. Only 1 patient (4%) showing keratin impacted in tonsilar tissue.

Conclusions: There is strong correlation between histopathological examination suggestive of lymphoid hypertrophy and grading of palatine tonsil hypertrophy.

Author Biographies

Sanjana V. Nemade, Department of Otorhinolaryngology, Smt Kashibai Navale Medical College, Narhe, Pune, Maharashtra, India

Dept of Otorhinolaryngology

Professor & Head of the department

Lakshmikant B. Yadav, Department of Otorhinolaryngology, Smt Kashibai Navale Medical College, Narhe, Pune, Maharashtra, India

Dept of Otorhinolaryngology

Junior Resident


Junqueira LC, Carneiro J. Histologia Básica. 9th edition. Guanabara Koogan, Rio de Janeiro. 1999;242-3.

Alves AL, Scala WAR, Barros MD, Dolci JEL. Análise histológica de 24 tonsilas faríngeas de pacientes submetidos àadenoidectomia ou àadenoamigdalectomia. Rev Bras Otorrinolaringol. 2002;68(5):615-8.

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(12):2166-9.

Ferreira JB. Histopatologia de amídalas e adenóides de 154 pacientes operados. Rev Port Otorrinolaringol. 2003;41(1):35-9.

Moore KL. Embriologia Clínica. Guanabara Koogan. Rio de Janeiro. 1996;4:259.

Freitas LPS. Epitélio especial da cripta amigdaliana. de Campos CAH, Costa HOOC, Editors. Tratado de Otorrinolaringologia. Roca, São Paulo. 2002;219-21.

Bogliolo L. Patologia oral e otorrinolaringológica. Patologia. Guanabara Koogan, Rio de Janeiro. 1991;1002-6.

Endo LH, Trevisan MAS, Horn LS. Actinomicose das amídalas palatinas valor do exame histopatológico de rotina. Rev Bras Otorrinolaringol. 1981;47(2)122-6.

Herton C, Guilherme TL. Procedimentos Cirúrgicos no Anel Linfático de Waldeyer. Tratado de Otorrinolaringologia. Técnicas Cirúrgicas, São Paulo. 2002;5:321-8.

Behmer OA, Tolosa EMC, Freitas de Neto AG. Manual de técnicas para histologia normal e patológica. Edant, São Paulo. 1976;239.

Brodsky L. Modern assessment of tonsils and adenoids. Pediatr Clinic N Am. 1989;36:1551-69.

Costa FN, Santos O, Weckx LLM, Pignatari SN. Estudo microbiológico do core e superfície das amídalas palatinas em crianças portadoras de faringoamigdalites de repetiçã o e hipertrofia adenoamigdaliana. Rev Bras Otorrinolaringol. 2003;69(2):181-4.

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.

Bhargava D. Tonsil actinomicosis: a clinicopathological study. Acta Trop. 2001;80(2):163-8.

Pransky SM, Feldman JI, Kearns DB, Billman GF. Actinomyces in obstructive tonsilar hypertrophy and recurrent tonsillitis. Arch Otolaryngol Head Neck Surg. 2000;117(8):883-5

Marin S, Alberto L, Soriano B, Gomz DA, Jose R. Estudio histopatológico en plezas de amigdalectomia y adenoidectomia: análisis costo-beneficio. An Otorrinolaringol Mex. 2000;45(2):6264.

Gomes CI, Sakano E, de Melo RRG. Doença da arranhadura do gato, diagnóstico diferencial das tumoraçõ es cervicais em pediatria. Rev Bras Otorrinolaringol. 1991;57(2):76-80.

Uğraş S, Kutluhan A. Chronic Tonsillitis can be diagnosed with histopathologic findings. Eur J Gen Med. 2008;5(2):95-103.






Original Research Articles