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PubMed1996

Malignant melanoma metastatic to the tonsil.

Metastasis to the oral cavity from melanoma arising in distant sites is very rare. The authors present three cases of melanoma metastatic to the palatine tonsil: two were cutaneous melanomas and one arose from the mucous membrane of the hard palate. Fewer than 30 cases of metastatic melanoma to the palatine tonsil have been reported, and none have been from mucosal melanoma originating from another mucosal primary site in the head and neck. From this perspective, one of the cases in this article is unique. The authors present clinical histories of the three cases of melanoma metastatic to the palatine tonsil. Two patients were still alive a substantial time after treatment. The case presentations indicate that careful examination of the head and neck should be part of the routine follow-up examination in all melanoma patients.

Adult↗
PubMed2000

Resection of cancer of the tongue base and tonsil via the transhyoid approach.

OBJECTIVE: To assess whether transhyoid resection of the tongue base and tonsil lesions is an effective approach to tumors involving this region compared with more traditional anterior surgical approaches that arbitrarily involve either segmental resection or division of the mandible. STUDY DESIGN: Retrospective review. METHODS: Since 1988, we have used a combined transhyoid and transoral approach to resect lesions involving the tongue base, tonsil, or both. Forty-one patients were identified who underwent surgical resection of lesions involving this region via this combined approach during this period. A stage-matched group of 41 patients was also identified in which patients underwent resection via traditional composite or mandibulotomy approaches and was used as a basis for comparison. Factors assessed included status of surgical margins, postoperative complications, degree of postoperative dysphagia, and long-term outcome. RESULTS: Comparison between the two groups revealed similar rates of negative surgical margins. Levels of postoperative dysphagia, notably severe primarily in patients with either T4 or recurrent disease, were also similar between groups. Complication rates, especially with regard to fistula occurrence and mandible-healing problems, were significantly lower in the transhyoid group. Analysis of long-term outcome revealed similar patterns with regard to disease status in both groups. CONCLUSIONS: The combined transhyoid and transoral approach is an effective surgical option for a number of lesions affecting the tongue base, tonsil, or both. Although similar to other approaches with regard to postoperative function and disease outcome, the transhyoid approach is associated with decreased postoperative morbidity. However, tumors that extend to involve the mandible or pterygoid musculature or skull base are probably best suited for traditional approaches that involve division of the mandible.

Carcinoma, Squamous Cell↗
PubMed2004

Cine magnetic resonance imaging: evaluation of persistent airway obstruction after tonsil and adenoidectomy in children with Down syndrome.

OBJECTIVE/HYPOTHESIS: Although usually successful, not all obstructive sleep apnea is cured by removal of the tonsils and adenoids (T&A). This is particularly true in children with Down syndrome and craniofacial anomalies. This is because of the multiple levels of obstruction in their airways, with obstruction present not only at the level of the tonsils and adenoids but also from base of tongue obstruction, soft palate collapse, and hypopharyngeal collapse. The cine magnetic resonance image (MRI) is useful in evaluating the upper airway in those patients who have not achieved a normal polysomnogram after T&A surgery. STUDY DESIGN: Prospective case series. METHODS: Fifteen children with Down syndrome who had previously undergone a T&A but continued to have abnormal postoperative polysomnograms underwent a cine MRI with fast gradient cine MRI images. RESULTS: The cine MRI identified different areas and levels of obstruction that ultimately affected the children's treatment courses. Recurrent adenoid tissue, glossoptosis, soft palate collapse, hypopharyngeal collapse, and enlarged lingual tonsils were identified. The results as well as several illustrative cases are presented. CONCLUSION: Cine MRI evaluates upper airway obstruction in children who may have multiple sources of obstruction causing their obstructive sleep apnea. This is particularly helpful in children with Down syndrome and craniofacial anomalies. This technology is useful in all children with complex upper airway obstruction.

Adenoidectomy↗
PubMed1986

Tongue and tonsil cancer: staging with US.

A prospective study on the value of ultrasound (US) for the staging of 70 cases of cancer of the tongue and tonsil was performed. A real-time, high-frequency transducer was used, and the examination was often coupled with endobuccal palpation. US did not visualize the tumor in nine of 42 cases of tongue cancer (seven stage T1 and two anterior stage T2 tumors); US accurately defined tumor size in 33 cases. The degree of in-depth extension and the location with respect to the median line (only four false results) were evaluated correctly. With regard to 28 tonsil cancers, US depicted extension from the tonsillar fossa to the tongue in all cases but one (13 of 14 cases). US is valuable for the detection of cervical lymph nodes associated with both tongue and tonsil tumors and is a safe and helpful technique for the follow-up of medium-size lesions. The major limitations of US include the nonvisualization of superficial lesions, reduced accuracy for evaluation of the extension of large tumors, and analysis of posterior pharyngeal extension.

Humans↗
PubMedDate not supplied

Hypernephroma metastatic to the palatine tonsils.

Review of the literature discloses 76 cases of carcinoma metastatic to the palatine tonsil. Of these cases reported or mentioned, 51 were detailed sufficiently or occurred frequently enough to allow analysis. We add two new cases of hypernephroma, and also study the courses of patients with primaries of the stomach, breast, lung and melanoma and seminoma. Bilateral tonsilar involvement is found to be very common in melanoma and not uncommon in seminoma and adenocarcinomas of the stomach and breast. It is uncommon for bronchogenic carcinoma and hypernephroma to metastasize to both palatine tonsils. When laterality is present the left tonsil is more commonly involved than the right, except by melanoma. Regarding neoplastic involvement of the primary organ, the left side gives rise to malignancies more often than the right side. Only seminoma has a high incidence of other metastases. The mean time interval between development of the primary and the tonsillar secondary is one year or less in seminomas, bronchogenic carcinomas and adenocarcinomas of the stomach, but 2 1/2 years or more for adenocarcinomas of the breast and kidney and melanomas. The mean time of survival after appearance of the tonsillar metastasis is nine months or less, regardless of the cell type of the primary malignancy.

Adenocarcinoma↗
PubMed2005

Oesophageal tonsil of the chicken.

The oesophageal tonsil of the chicken is a novel member of the mucosal-associated lymphoid tissue (MALT), which is located around the entrance of the proventriculus. It consists of 6 to 8 single units, which are surrounded by a thin fibrous capsule. Each one is organised around the bottom of the longitudinal folds of the oesophagus, and serves as a 'tonsillar crypt'. Stratified squamous epithelium is infiltrated by lymphoid cells, i.e. T cells, plasma cells, macrophages, and dendritic cells, but not B cells, to form lymphoepithelium (LE). In the LE vimentin-, MHC II- and ATPase-positive cells possibly represent Langerhans' cells, but the appearance of 74.3 positive cells in the LE is unusual, because the 74.3 monoclonal antibody (mAb) recognises chicken follicular dendritic cells in the germinal centre and medulla of the bursal follicles. The subepithelial lymphoid tissue is organised into T- and B-dependent regions, which are the interfollicular areas and the germinal centres, respectively. Existence of high-endothelial venules in the interfollicular region suggests an extensive cellular connection between the oesophageal tonsil and the other lymphoid organs. In the resting oesophagus the lumen is closed, but during swallowing a bolus the crypt opens and the lymphoepithelium can be exposed to undigested food, antigens, infectious agents and vaccines. The location of the oesophageal tonsil, cranial to the stomach, may provide this organ with a unique role as compared to the other parts of the MALT; namely, it may contribute to the replication of infectious bursal disease virus (IBDV) and/or the pathogenesis of infectious bursal disease.

Animals↗
PubMed2001

[The role of Epstein-Barr virus (EBV) infection in carcinogenesis of palatine tonsil carcinoma (PTC)].

OBJECTIVES: Casual link of Epstein-Barr Virus (EBV) and endemically manifesting nasopharyngeal carcinoma has been already well documented. Our study, conducted in Karol Marcinkowski University of Medical Sciences in Poznań, aimed at examining whether EBV infection occurs also in patients with another tumor, palatine tonsil malignant neoplasms. METHODS: The studies were performed on 20 patients, aged 32 to 80 years, in whom tonsil malignencies was diagnosed by histological methods. The treatment of choice was surgery. Sera of the patients was tested for EBV DNA (Sharp Signal System; Digene), IgM-anti-EBV antibodies (Behring), IgG-anti-EA antibodies (ETI-EA-G; Dia Sorin) and IgG-anti-VCA antibodies (ETI-VCA-G; Dia Sorin). RESULTS: Serological exponents of reactivated EBV infection (serum IgG-anti-EA and IgG-anti-VCA antibodies) were observed in 12 patients. In parallel, ten of the patients demonstrated EBV DNA. In the remaining 8 patients, three manifested past EBV infection (positive IgG-anti-VCA) and five probed to be EBV negative. CONCLUSIONS: The results indicated, that tonsil malignancies may be associated with EBV infection.

Antibodies, Viral↗
PubMed2002

[Prognostic factors in patients with primary non-Hodgkin's lymphoma of the tonsil].

OBJECTIVE: To investigate the prognostic value of the size of primary tumor (T staging) and international prognostic index (IPI) for patients with non-Hodgkin's lymphoma (NHL) of the tonsil, and to recommend the treatment strategy for early stage patients. METHODS: 306 patients with untreated NHL of the tonsil were reviewed. According to Ann Arbor staging classification, 35 patients had stage I, 178 stage II, 49 stage III and 44 stage IV disease. According to 1997' AJCC staging system, 29 patients had T1, 142 T2, 117 T3 and 18 T4 disease. Twelve stage I patients were given radiotherapy alone and 23 stage II patients were given combined modality therapy (CMT). For patients with stage II lesion, 57 were given radiotherapy alone, 2 chemotherapy alone and 119 CMT. Chemotherapy was the main treatment in patients with stage III or IV lesions. RESULTS: The 5-year cancer specific survival (CSS) was 74% for patients with T(1), 59% for T(2), 56% for T(3) and 26% for T(4), respectively (P = 0.000). The 5-year CSS was 70% for patients with 0 risk factor, 49% for 1 risk factor, 25% for 2 or 3 risk factor, respectively (P = 0.000). CMT significantly improved disease free survival (DFS) from 46% (radiotherapy alone) to 60% (CMT) for stage II patients (P = 0.046). Multivariate analysis showed that performance status, Ann Arbor staging, T staging, B symptom, and IPI were independent prognostic factors. CONCLUSION: The T staging of the primary tumor and IPI are the important prognostic factors of patients with NHL of the tonsil. Combined modality therapy significantly improves the disease free survival of stage II patients.

Adolescent↗
PubMed2002

[Localized recurrence of acute lymphoblastic leukemia-L3 in the tonsil after 3-years' remission].

Recurrence of Burkitt's lymphoma (BL)/acute lymphoblastic leukemia (ALL)-L3 after a long-term remission is very rare. We herein report on a case of BL/ALL-L3 indicating solitary recurrence in the tonsil after a 3-year remission. A 50-year-old man was diagnosed as having Burkitt's type ALL-L3 with involvement of the stomach and abdominal lymph nodes. He was treated with intensive chemotherapy consisting of methotrexate and cyclophosphamide (ALL-BFM86 protocol), and a complete remission was achieved. After sustaining the remission for three years, a swelling of the right tonsil was observed, which was histologically diagnosed as Burkitt's lymphoma. No other organ involvement, including the bone marrow, was observed. The pattern of c-myc rearrangement of the tonsil demonstrated by southern blotting was identical to that of the bone marrow at initial presentation and the recurrence of primary ALL-L3/BL was thus confirmed. The patient was then treated with the ALL-BFM86 protocol and subsequently underwent high-dose chemoradiotherapy with autologous peripheral blood stem cell transplantation (PBSCT). He has now been in complete remission for more than 2 years after his PBSCT.

Humans↗
PubMed2003

Follicular dendritic cell sarcoma of the tonsil: report of a rare case.

Follicular dendritic cell tumors are extremely rare. Only 17 cases have been previously described in the literature, and only three of them involved primary tumours of the oral cavity. We describe a new case of the latter, which occurred in a 51-year-old man who sought evaluation for a painless enlargement of his left palatine tonsil. The tonsil was excised, and histologic examination revealed that the tumor was a primary sarcoma that had arisen from the dendritic reticulum cells of the palatine tonsil. Postoperatively, the tumor site was treated with percutaneous irradiation (total dose: 70 Gy). After more than 5 years of follow-up, the patient showed no evidence of recurrence. We also discuss the salient features of the immunohistochemical examination.

Biopsy, Needle↗
PubMed1977

[On the physiopathologic reactions of pharyngeal tonsil from the clinical standpoint (author's transl)].

On the basis of personal experiences the authors isolate two forms of pharyngeal tonsil hypertrophy: a physiological and a pathological one. The first one corresponds to the requirements of the organism which is not completely mature immunologically, it may be quite considerable but causes no disturbances in breathing through the nose or in the function of Eustachian tubes. The pathological hypertrophy of pharyngeal tonsil is due to a parenchymal inflammation caused by viruses with a typical pathogenesis. The authors describe six diagnostic criterias of the pathological hypertrophy of pharyngeal tonsils. Using these criter as they analysed 100 cases of adenotomy from the year 1969 and they have found that in only 38 cases the operation was done for pathological hypertrophy while in 62 cases hypertrophy was physiologic. Adentomy gives good results in cases of pathological hypertrophy but in cases of physiologic hypertrophy it may cause adverse results.

Adenoidectomy↗
PubMed2005

[The hypertrophy of pharyngeal tonsill in the estimation of XIX-century physicians].

The role of such physicians as Rudolph A. Kolliker, Johann N. Czermak, Ludwig Tuerck, Friedrich E. Voltlini, Benjamin B. Loewenberg, Hubert v. Luschka in the building of the science on hypertrophy of pharyngeal tonsil are pointed out first of all. The specific significance of achievements of Wilhelm Meyer (1824-1895) of Copenhagen based on scrupulous examinations is described. In the Polish territories the innovatory were works of Teodor Heryng, Klemens Koehler, Władysław Wróblewski, Jan Sedziak, Teofil Zalewski. The epidemiology, etiology, pathogenesis, anatomo-patological examinations, the role of pharyngeal tonsil on immunity system are presented widely. The influence of hypertrophy of pharyngeal tonsil on general evolution of child, on his intellectual sphere, on speech disorders, on upper respiratory tract disorders, on auditory disorders, on the origination of deaf-mutism, on the origination of reflexogenous neuroses are described in more detail. An important role of anterior rhinoscopy, posterior rhinoscopy, and digital examination in the diagnosis of this illnes are also presented with full particulars.

Adenoidectomy↗
PubMed1987

[Embryogenesis of the human pharyngeal tonsil].

By means of histological, histochemical, immunological and morphometric methods 78 pharyngeal tonsils of human embryos at the age of 12-40 weeks have been investigated. The character of the organ's anlage at 12-14 weeks of development as longitudinal folds on the dorsal wall of the rhinopharynx and changes in correlation of the lymphoid and epithelial tissues are presented in the process of the tonsil embryogenesis. Occupation of the organ with lymphocytes takes place on the 16th week of development. The embryos possess already two classes of T- and B-lymphocytes and their subclasses: auto-E-RFC, EAC-RFC, IgM and IgG positive cells; their kinetics is demonstrated in the process of the organ's development. A comparison on lymphocyte quantity, participating in cell-dependent immunity of the tonsil in fetuses, children and mature persons is presented.

Adenoids↗
PubMed1978

Cancer of the tonsil--a retrospective study.

Treatment of cancer of the tonsil continues to be a controversial matter. A review of the otolaryngological literature and a study of 155 patients treated at the University of British Columbia reveals that the cure rate remains unsatisfactory, particularly in patients with large tumors. We have concluded that early carcinoma of the tonsil should be treated with a full course of radiotherapy reserving surgical treatment for residual or recurrent disease. Advanced carcinoma of the tonsil requires planned combined therapy. Early results indicate that the addition of chemotherapy may significantly improve results over the usual combination of radiotherapy and surgery.

Adolescent↗
PubMed1994

The effect of hypertrophic adenoids and tonsils on the development of posterior crossbite and oral habits.

There are a number of studies in the literature, that associate nasopharyngeal airway obstruction, as a result of adenoid enlargement, to the development of skeletal and dental abnormalities. However, the etiologic role of hypertrophied adenoids and tonsils in developing an aberrant dentofacial growth is not clear, yet. The present investigation attempted to study the incidence of maxillary posterior crossbite and oral habits, in a sample of 120 children, that displayed hypertrophied adenoids with or without enlarged tonsils, and underwent adenoidectomy. An attempt was also made to relate the presence of crossbite to the severity of upper respiratory airway obstruction. The severity of airway obstruction was assessed using radiographic and surgical criteria. A lateral cephalometric radiograph was obtained and studied for each patient. Results indicated, that 47% of the children examined, had developed a posterior crossbite. The presence of crossbite was high in children with severe airway obstruction, particularly in those with hypertrophied adenoids and tonsils. On the contrary, most of the children with a posterior crossbite did not have a history of pacifier or finger sucking. It was also concluded, that the study of a lateral cephalometric radiograph can be a valuable diagnostic method in the evaluation of children with upper airway obstruction.

Adenoids↗
PubMed1977

[Follow-up surgery for carcinoma of the tonsil (author's transl)].

This study involves the frequency, techniques and results of follow-up surgery for carcinoma of the tonsil treated by transcutaneous radiotherapy. Local or lymph node failures affect 65% of patients treated by radiation. Follow-up surgery was used in 86% of these failures. After reviewing the various techniques and their oncological results, the authors discuss the best timing for follow-up surgery. They compar their results of surgery in the case of sub-total treatment, surgery for recurrences and routine surgery two months after the end of transcutaneous irradiation. The results are in favour of routine surgery. If it is accepted, since this point is open to discussion, that radiotherapy remains the appropriate initial, and sometimes adequate, treatment for carcinoma of the tonsil, the frequency of local and lymph node recurrences should lead to the indication, in certain cases, for complementary surgical therapy. This routine additional surgical treatment should be discussed in the context of the initial protocol of the treatment of a carcinoma of the tonsil.

Electrocoagulation↗
PubMedDate not supplied

Appearance of T cells in the bursa of Fabricius and cecal tonsils during the acute phase of infectious bursal disease virus infection in chickens.

Groups of 3-wk-old specific-pathogen-free chickens were inoculated intraocularly with two virulent and one vaccine strain of infectious bursal disease virus (IBDV). During the acute phase of infection, the bursa of Fabricius and cecal tonsil were examined by immunohistochemistry for IBDV antigen and T cell. With all three viruses examined, the infection resulted in the appearance of viral antigen in the bursa accompanied by the presence of CD3+ cells. The CD3+ cells were predominantly TCR2+ and appeared at the site where viral antigens were present. The CD3+ cells continued to persist in the bursa after most of the IgM+ cells and IBDV antigen-positive cells had disappeared. Similar appearance of CD3+ cells was noted following viral antigen accumulation in the germinal centers of cecal tonsils in virulent IBDV-infected chickens. These results demonstrated that infection with IBDV resulted in extensive viral replication in the bursa and the cecal tonsils with an associated accumulation of T cells. The role these T cells may play in the pathogenesis of IBDV infection remains to be established.

Animals↗
PubMed1998

[A case of rectal cancer metastatic to the tonsil].

Metastatic tumors of the tonsils are rarer than primary tumors. Few cases of metastatic tonsillar tumor have been reported. A 51-year-old man expectorated a portion of a tumor from the left side of the pharynx after an operation for cancer metastatic to the lung. Biopsy revealed that the pharyngeal tumor was rectal cancer (adenocarcinoma) metastatic to the tonsil. To our knowledge, this is the first case of primary rectal cancer metastatic to the tonsil to be reported in Japan. The clinical features of metastatic tonsillar tumor are discussed.

Adenocarcinoma↗