Cassie L Booth1, Jun Wang. 1. Department of Pathology and Laboratory Medicine, 11234 Anderson St Room 2151, Loma Linda, CA 92354; jwang@llu.edu.
Abstract
OBJECTIVES: Handling of tonsillectomy specimens often includes gross and histologic examination. The published incidence of occult malignancy in benign-appearing tonsils is vanishingly rare, and consequently some propose omitting histologic analysis in young patients without clinical risk factors for malignancy or grossly suspicious features. METHODS: At our institution, an occult Burkitt lymphoma in a grossly benign-appearing tonsil from an otherwise healthy 5-year-old prompted review of our cases. We retrospectively reviewed tonsillectomy findings over a 5-year period, excluding patients with known lymphoma or head and neck malignancies. A total of 740 patients were identified. All cases underwent gross and histologic examination. RESULTS: Four additional malignancies were diagnosed, including a clinically unsuspected lymphoma in a 14-year-old patient. In our experience, although most tonsillar malignancies present with suspicious clinical or gross findings, occult malignancies do occur. CONCLUSIONS: Recognition of these occult findings may facilitate early diagnosis and treatment; thus pathologic study of these specimens may still be justified.
OBJECTIVES: Handling of tonsillectomy specimens often includes gross and histologic examination. The published incidence of occult malignancy in benign-appearing tonsils is vanishingly rare, and consequently some propose omitting histologic analysis in young patients without clinical risk factors for malignancy or grossly suspicious features. METHODS: At our institution, an occult Burkitt lymphoma in a grossly benign-appearing tonsil from an otherwise healthy 5-year-old prompted review of our cases. We retrospectively reviewed tonsillectomy findings over a 5-year period, excluding patients with known lymphoma or head and neck malignancies. A total of 740 patients were identified. All cases underwent gross and histologic examination. RESULTS: Four additional malignancies were diagnosed, including a clinically unsuspected lymphoma in a 14-year-old patient. In our experience, although most tonsillar malignancies present with suspicious clinical or gross findings, occult malignancies do occur. CONCLUSIONS: Recognition of these occult findings may facilitate early diagnosis and treatment; thus pathologic study of these specimens may still be justified.
Authors: Kaitlyn Tholen; Olivia Kalmanson; Christian R Francom; Jeremy D Prager Journal: Int J Pediatr Otorhinolaryngol Date: 2021-09-27 Impact factor: 1.675