[Adenoids and adenoiditis in the physiology and pathology of childhood]

Histological and immunohistochemical studies of surgically removed adenoid vegetations (a group included 100 children aged 2 to 14 years) have established that adenoids represent pharyngeal tonsils with lymphoid tissue hyperplasia that reflects a cooperative immune response with the participation of various cell populations and subpopulations of cellular and humoral immunities. An immune response is induced outside through the specialized structures of the reticular epithelium that expresses HLA-DR molecules. The pharyngeal tonsil is shown to be not only an inductive organ of mucosal immunity, but also an organ that realizes an effector response of the immune system in complex with the mechanisms of nonspecific defense. Age-related morphologic changes reflect the preponderance of cellular immunological responses in young children and the higher humoral immunological responses as the child becomes adult. Whether there is a need for organ-preserving treatment of chronic adenoiditis is discussed.