Tonsillar hyperplasia and recurrent tonsillitis: clinical-histological correlation

Abstract

Hypertrophy and recurrent tonsillitis are common indications of tonsillectomy. However, the pathological reports are similar, regardless of clinical aspects. ObjectiveSearch for histopathological changes that differentiate palatine tonsils operated because of hypertrophy vis-à-vis those operated because of recurrent tonsillitis. MethodA prospective cross-sectional descriptive study involving 46 children divided into group I - 22 with hypertrophy; and group II - 24 with recurrent tonsillitis, in the period between 2010 and 2012, in a public hospital. We evaluated clinical and histopathological features (lymph follicles, germinal centers, fibrosis, necrosis, reticulation, infiltration by plasma cells and neutrophils). ResultsThe patients' ages ranged between 2 and 11 years (5.17 ± 2.28). In group I, half of the patients had had the latest infection at seven months or more, and all with obstruction degree greater than 3 (≥ 50%). In group II, all had had the latest infection at less than seven months, and most with obstruction degree below 4 (≤ 75%). There was a statistically significant difference in the degree of obstruction (p = 0.0021) and number of germinal centers (p = 0.002) was higher in group I. ConclusionThis study suggests that the number of germinal centers is the only histopathological criterion that can be used to differentiate the two groups.