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Rev Bras Otorrinolaringol. V.71, n.1, 18-22, jan./feb. 2005

ARTIGO ORIGINAL ORIGINAL ARTIC LE

Histological analysis of tonsillectomy and adenoidectomy specimens January 2001 to May 2003
Alfredo R. Dell’Aringa 1, Antônio J. C. Jua res 2, Cinthia de Melo3, José C. Nardi4, Ka zue Koba ri5, Renato M. Perches Filho6

Palavras-chave: adenotonsilectomia, histopatológica. Key words:adenotonsilectomy, hispathologic.

Summary
alatine and nasopharyngeal tonsils are nonencapsulated nodular masses of lymphoid tissue of the respiratory and digestive tract epithelium. Study design: Retrospective clinical study based on the revision of medical records of patients who underwent tonsillectomy and adenoidectomy at Hospital das Clínicas, Medical School, Marília in the period between January 2001and May 2003. Aim: Analysis of patients’ profile and main pathological changes in 250 patients with palatine and nasopharyngeal tonsil hypertrophy, recurrent infections or both. Material and method: Histological review of 250 patients who underwent tonsillectomy and adenoidectomy among adults and children. Results: Out of 250 subjects, 117 (46.8%) were female and 133 (53.2%) were male patients.Mean age was 7.3 years, ranging from 2 to 34 years. Main surgical indication was concomitant presence of recurrent infections and hypertrophy of nasopharyngeal and palatine tonsils. Among these patients, 160 (64%) were classified as grades III to IV hypertrophy. Lymphatic or follicular lymphatic hyperplasia was observed in 205 patients (82%); focal inflammation was verified in 45 (18%) subjects.Among those, 2 patients presented squamous cell cysts, 2 had Actinomyces sp colonies and 1 cat scratch disease. Discussion: The results presented in this study suggested a possible correlation between recurrent tonsillitis and palatine tonsil hypertrophy. Conclusion: Routine histological study of tonsillectomy and adenoidectomy specimens has a low cost-benefit rate, although, due to legal andethical issues, physicians may request this type of examination.

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Ph.D. and Head of the Discipline of Otorhinolaryngology, Medical School, Marília. 2 Resident Physician in Otorhinolaryngology. 3 Resident Physician in Otorhinolaryngology 4 Master and Professor, Discipline of Otorhinolaryngology. 5 Professor, Discipline of Otorhinolaryngology. 6 Resident Physician in Otorhinolaryngology. Disciplineof Otorhinolaryngology - Medical School, Marília - Av Monte Carmelo, 800 Fragata, Marília SP CEP: 17519-030. TEL: (55 14) 421-1744. - e-mail: orl@famema.br Article submited on March 05, 2004. Article accepted on January 20, 2005.
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REVISTA BRASILEIRA DE OTORRINOLARINGOLOGIA 71 (1) P ART 1 J ANUARY/FEBRUARY 2005 http://www.rborl.org.br / e-mail: revista@aborlccf.org.br

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INTRODUCTIONPalatine and nasopharyngeal tonsils are lymphatic flesh clusters of tissue of the respiratory and digestive tract’s epithelium. Classification by site includes palatine, lingual and pharyngeal tonsils. They have important role in the body’s immune system, once they are near the entrance to the breathing passages where incoming antigens may be aspirated or ingested1,2. The palatine tonsils are thelateral walls that compose the bulk of the so-called Waldeyer’s ring of lymphatic tissue1. They are coated by non-keratinous stratified epithelium, as an extension of the oral pharyngeal tissue, including 30 deep crypts that invaginate into the parenchyma, in which lymph nodes are found with the germ centers responsible for Blymphocyte production1,3. In addition to nodes, debris of epithelial cellsdesquamations, alive and dead lymphocytes, as well as bacterium may be present in the crypts. In cases of acute tonsillitis, collection of pus may be observed4. They are coated by fibrous and dense capsule, separating them from a deeper connective tissue1,2. This type of tonsils originates from the second pair of pharyngeal pouches, where endodermis bears the covering epithelium and mesenchymal...