[Histomorphological changes induced by recurrent tonsillitis]

Palatine tonsils are lymphoepithelial mucosal structures whose particular role as a defense mechanism in the human immune system makes them fundamental in protecting organs of much greater importance. If follows, therefore, that dealing with recurrent tonsillar phlogosis--diagnosis as well as therapy choice, surgical or medical--is today problematic and shrouded in doubt. The authors examined tonsillar tissue specimens of 65 patients (age range 4-30 years) who had previously undergone tonsillectomy. Light microscopy and immunocytochemistry were used to study subepithelial tissue while scanning electronic microscope was employed to observe epithelial ultrastructure in order to determine which alterations were most meaningfully correlated to the history and clinical picture of the subjects. In 100% of the cases the cryptic reticular epithelium was hyperplastic while in 44% a squamous metaplasia was observed. Epithelial alteration in various forms was also revealed with scanning electronic microscope: cellular disjunction ridging of the cryptic floor, conrifying squamous epithelial cells, plasma cells and infiltrated lymphocytes. The authors suggest that it is precisely epithelial alteration which, due to inadequate antigen uptake, triggers the series of events which leads from tonsillar disorders to systemic metafocal manifestation.