Oral tonsils: Location, distribution, and histology

Abstract

This report deals with the routine oral examination of 503 randomly selected male patients. In 21 per cent of these patients, small, circumscribed, nodular structures, 1 to 3 mm. in diameter, were observed on the mucosa of the soft palate; 5 per cent of the patients had similar structures on the ventral surface of the tongue; and 12 per cent had them on the floor of the mouth. These structures, which histologically resemble the tonsils of Waldeyer's ring, should be called oral tonsils. They ranged in number from one to twenty-five and were randomly located on the soft palate. Similar structures occurred on the ventral surface of the tongue ranging in number from one to six, and on the floor of the mouth, where they ranged in number from one to sixteen. They were asymptomatic, and in six cases biopsies revealed a central crypt, continuous with the surface epithelium, which was lined with stratified squamous epithelium around which a circumscribed mass of nodular and diffuse lymphoid tissue could be seen. It has been suggested that the oral tonsils are normal in the oral mucosa and, unless they become large, infected, or symptomatic, require no excision. Oral tonsils on the ventral surface of the tongue should be distinguished from salivary gland duct orifices. It is possible that some of the lymphoepithelial lesions described in the literature in reality represent normal oral tonsils.