Clinical Evaluation of the Tonsils for Malignancy: The Necessity of Histopathological Examination

ABSTRACT Background and Objectives: Tonsils are lymphoid tissues that can be affected in various diseases. In some cases, it is necessary to remove tonsils through surgery. Although the diseases are often diagnosed by history-taking and physical examination that proceeds with surgery, histologic examination is necessary for confirmed diagnosis of malignancy. Considering the low prevalence of tonsil cancer, this study was performed to clinically examine tonsils for malignancies and evaluate the necessity of histopathological examination. Methods: This retrospective study was conducted on 2,232 patients (aged 2-80 years) who had undergone tonsillectomy for various reasons in the city of Gorgan from 2001 to 2012. Medical history was obtained and physical examination was carried out before surgery. All the obtained samples were sent to the laboratory for histopathological examination. Finally, the collected data was analyzed. Results: Only one case of lymphoma was found among the 2,232 patients investigated in this study. This 80-year-old woman with preoperative cervical lymphadenopathy and unilateral tonsillar enlargement went under tonsillectomy for confirmed diagnosis. Conclusion: Considering the high frequency of tonsillectomy and the low possibility of malignancy, and the fact that malignancy is often seen in individuals with obvious clinical presentations such as in our case, it is recommended to limit referral of specimens for histological examination to highly suspicious cases through more rational decision-making and summarization of other findings. Keywords: Hypertrophy, Malignancy, Lymphoma Pathology, Tonsillectomy