Actinomycosis in the etiology of recurrent tonsillitis and obstructive tonsillar hypertrophy: answer from a histopathologic point of view.
OBJECTIVE
To investigate the histopathologic profile and clinical presentation of tonsillar disease in the presence of Actinomycetes in children.


METHODS
A qualitative and quantitative histopathologic analysis of the palatine tonsil was performed.


METHODS
Tonsillectomy specimens from patients who underwent tonsillectomy or adenotonsillectomy were searched for Actinomycetes.


METHODS
Histologic evaluation of the specimens was done on hematoxylin and eosin-stained slides as blinded to patients' clinical category for disease groups.


METHODS
Four histologic compartments of the tonsil, including the surface epithelium, reticulated crypt epithelium (lymphoepithelium), lymphoid tissue, and interfollicular region, were examined.


RESULTS
Actinomycetes was more prevalent in patients with obstructive symptoms treated with adenotonsillectomy. The number of subjectively quantitated total lymphoid follicles and small and medium-sized lymphoid follicles of the palatine tonsil were significantly increased in patients demonstrating "sulphur granules" in their crypts. Highly thick squamous metaplasia of the lymphoepithelium and dilatation of crypts were more prevalent in tonsil tissue revealing Actinomycetes.


CONCLUSIONS
The presence of Actinomycetes in tonsillectomy specimens does not indicate active tissue infection. However, the histopathologic outcome may indicate the possible etiologic role of Actinomycetes in the development of prominent lymphoid hyperplasia and hypertrophy and, in turn, obstructive tonsillar hypertrophy.
Ozgursoy
Ozan Bagis
OB
Department of Otorhinolaryngology-Head and Neck Surgery, University of Ankara, Faculty of Medicine, Ankara, Turkey. ozanozgursoy@yahoo.com
Kemal
Ozgur
O
Saatci
Mustafa Rahmi
MR
Tulunay
Ozden
O
D000190:Actinomyces / Q000302:isolation & purification*; D000196:Actinomycosis / Q000150:complications* / Q000473:pathology* / Q000601:surgery; D000233:Adenoidectomy; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006984:Hypertrophy / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D008297:Male; D014066:Palatine Tonsil / Q000382:microbiology / Q000473:pathology*; D012307:Risk Factors; D014069:Tonsillitis / Q000382:microbiology* / Q000473:pathology* / Q000601:surgery