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Updated: Jul 12, 2026
07:38
Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue
Published on: June 14, 2020
Routine histologic examination is unnecessary for tonsillectomy or adenoidectomy
David A Randall1, Peter J Martin, Lester D R Thompson
1Springfield Ear, Nose, Throat and Facial Plastic Surgery, Springfield, Missouri 65804, USA. d.randall@springfieldent.com
The Laryngoscope
|September 1, 2007
Summary
Histologic examination of tonsillectomy and adenoidectomy specimens is often unnecessary. Only submit specimens when suspicious signs of malignancy are present to optimize resource use.
Area of Science:
- Otolaryngology
- Surgical Pathology
- Oncology
Background:
- Tonsillectomy and adenoidectomy are common procedures.
- Histologic examination of surgical specimens is standard practice.
- The cost-effectiveness and necessity of routine examination are debated.
Purpose of the Study:
- To evaluate the diagnostic yield and cost-effectiveness of routine histologic examination of tonsillectomy and adenoidectomy specimens.
- To identify specific clinical indicators that warrant submission for pathologic analysis.
Main Methods:
- A comprehensive literature review was performed using PubMed.
- Included studies focused on tonsillectomy, adenoidectomy, and surgical pathology.
- References from retrieved articles were also reviewed for additional relevant sources.
Main Results:
- Analysis of 54,901 patients across 20 studies revealed a malignancy prevalence of 0.087%.
- Of 54 malignancies, 88% presented with preoperative suspicious features (e.g., asymmetry, lymphadenopathy).
- True occult malignancies without suspicious features were found in only 0.011% of cases.
Conclusions:
- Routine histologic examination of tonsillectomy and adenoidectomy specimens is not consistently warranted.
- Specimen submission should be reserved for cases with clinical findings suggestive of malignancy.
- Key indicators include tonsillar asymmetry, history of cancer, neck mass, abnormal tonsil appearance, weight loss, and constitutional symptoms.
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