Histopathological concept of chronic tonsillitis in children

The purpose of this study was to ascertain to what degree the clinical entity recurrent tonsillitis (RT) is associated with a histopathological pattern of chronic tonsillitis. Cases of idiopathic tonsillar hypertrophy (ITH) not associated with recurrent infections were used for comparison. We performed a histopathological study of 126 palatine tonsils of children (57 cases due to RT and 69 due to ITH). The following features were evaluated: cryptal reticulation, the relative amount of diffuse and follicular lymphoid tissues, the intensity of parenchymal fibrosis, the papillary arrangements of the epithelium, the amount of debris in the lumen of the crypts, and the presence of keratin cysts. There was no significant quantitative difference between the two groups (RT and ITH) and we did not find a histological distinctive pattern of RT or ITH. Recurrent infection in the tonsils in children is not associated with a histopathological pattern which could be termed chronic non-specific tonsillitis and is clearly distinguishable from idiopathic tonsillar hypertrophy.

Histopathological comparison between tonsil and adenoid responses to allergy

In a previous study of adenoid tissue from allergic and non-allergic patients, we concluded that in allergic children edema of the "chorium" was present in 80.4% and that treatment with antihistamine drugs may reduce this edema. The purpose of the present study was to compare the histopathology of the palatine tonsil and adenoid from allergic patients. Tissue samples were obtained from 153 patients (56 tonsils and 97 adenoids from allergic children). We analysed the intensity of the edema and its cellular components in the chorium of palatine tonsils and adenoids. The frequently seen edema in the adenoids was significantly different from that in the tonsils. The squamous epithelium of the tonsils was thicker and bad stronger intercellular junctions than the columnar epithelium of the adenoids. This fact probably makes difficult the contact of the antigen with the chorium.