Histologic analysis of pediatric tonsil and adenoid specimens: is it really necessary?

OBJECTIVE To evaluate the incidence of unexpected histologic findings in routine tonsillectomy and adenoidectomy specimens. METHODS A retrospective medical record review was performed at a tertiary care children's hospital. The pathology records of 2062 children who underwent tonsil or adenoid surgery were analyzed and the final histologic diagnosis was recorded. RESULTS Four unexpected histologic findings were found on routine tonsil and adenoid specimens. None were clinically significant. A review of the literature shows a very low rate (0.015%) of unexpected clinically significant diagnoses in pediatric adenotonsillectomy specimens. CONCLUSIONS Given rarity of unexpected clinically significant diagnoses in pediatric adenotonsillectomy specimens, the cost and effort of analyzing each specimen histologically is difficult to justify.