Back pain: an unusual presentation of Castleman's diseases.

ipsilateral absence of tonsil and microtia with ectopic salivary gland was reported by Sinha & Singh in 1978.This patient presented with left external ear deformity with conductive hearing loss His oropharyngeal examination found ipsilateral absence of tonsil and ectopic salivary gland in the posterior part of the tongue. In 1985 Grewal, Hiranandini and Kalgutkar reported 4 cases of congenital external ear deformity with conductive hearing loss along with unnoticed ipsilateral congenital absence of palatine tonsil. In reported cases lowest age was 6 and highest was 18. In our case 28 year old male presented with the features of acute tonsillitis of right tonsil with absence of left tonsil without external ear deformity, hearing loss or any other congenital abnormality. Here absence of tonsil is an incidental finding. A case presents with congenital external ear deformity one must search for absence of palatine tonsil. But the patient presents with absence of one palatine tonsil without external ear deformity, the findings may remain unnoticed and lately presented following an acute attack of the opposite one. Congenital unilateral absence of tonsil is a very rare condition. Early diagnosis is possible along with external ear deformity. Agenesis of one tonsil without external ear deformity may have delayed or incidental presentation.