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Updated: May 6, 2026
Isolation of Tonsillar Mononuclear Cells to Study Ex Vivo Innate Immune Responses in a Human Mucosal Lymphoid Tissue
Published on: June 14, 2020
Occult hematologic malignancy in routine tonsillectomy specimens: a single institutional experience and review of the
1Department of Pathology and Laboratory Medicine, 11234 Anderson St Room 2151, Loma Linda, CA 92354; jwang@llu.edu.
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.
