Tonsil hypertrophy

Introduction Tonsils hyperemia and hypertrophy are generally characterized by tonsillar blood red, swollen, visible bloodshot, painful. Most of the tonsil-filled hypertrophy occurs when the body's resistance is reduced, and it is caused by bacteria or viruses. It is an acute onset and usually occurs in chronic tonsillitis.

Cause

In chronic tonsillitis, epithelial necrosis in the crypt, bacterial and inflammatory exudate accumulate, the crypt can produce small ulcers and scar formation and poor drainage, suitable for bacterial growth and reproduction, so the infection is not easy to eliminate. Repeated acute tonsillitis, the body's resistance is reduced or the treatment is not complete, it is easier to turn chronic. The pathogenesis of this disease is still unclear, but in recent years, based on the immunological point of view, it is considered that its own allergic reaction is an important mechanism for causing chronic tonsils.

an examination

Related inspection

Otolaryngology CT examination of nasopharyngeal MRI

According to the medical history, combined with the above symptoms and signs for diagnosis, rather than the size of simple tonsils, because with the increase of age, tonsils are shrinking, chronic tonsillitis is divided into three types, namely proliferative, fibrous And crypt type, so the size of the tonsils does not indicate the degree of inflammation, so it cannot be diagnosed.

Examination showed that the tonsil was chronically congested, the surface of the tonsil was uneven, scars, and it was implicated in the surrounding tissues. Sometimes the crypts were closed, showing yellow-white dots, which were covered with a thin mucous membrane or adhesion. There may be purulent secretions or cheese-like secretions at the opening of the crypt, and secretions may overflow when squeezed. The tongue and the pharyngeal arch are congested. Mandibular lymph nodes are enlarged.

When chronic tonsillitis has caused systemic complications, the serum A, gamma globulin and mucin are abnormally increased, while the reactive protein test is mostly positive. The anti-streptolysin "O" has higher titer and more erythrocyte sedimentation rate. accelerate. By immunohistochemical examination, amino acid quantification, high serum 2 protein, is important for focal tonsillitis. Using electron microscopy and serum fluorescent antibody examination, the mass change of tonsil formation (IgG predominance) was determined in the tonsil tissue sections, and it was confirmed that this change was mainly located in the crypt-lymphatic stroma (the latter under normal conditions) Without this function, there is sufficient evidence to suggest that there are potential or active lesions in the tonsil.

Differential diagnosis

1. Keratoosis of tonsil: hyperkeratosis of the epithelial cells of the tonsil crypt, shaped like yellow-white horns or pointed sand-like keratin, hard to touch, firm foundation, can not be wiped off, no Obvious symptoms, or anti-pharyngeal discomfort or foreign body sensation, can occur at the posterior pharyngeal wall, pharyngeal side and tongue base. The course of the disease is longer, mostly occurring in young people before the age of 30. The cause is not clear and generally does not require special treatment.

2. Tonsil tumors: One side of the tonsil is rapidly enlarged or the tonsils are swollen and ulcerated, and the possibility of tumor should be considered. Such as tonsil sarcoma, early can be confined to the tonsil mucosa, the surface is smooth, the main symptoms are one side of the tonsil rapidly increased, often cervical lymph node metastasis, more common in young people, biopsy can be diagnosed.

3. Tonsillary hypertrophy: a local manifestation of certain systemic diseases, such as when suffering from leukemia, the tonsils may be symmetrically enlarged. Sometimes pharyngeal symptoms can be their first symptoms. Diagnosis is based on peripheral blood and bone marrow.

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