Histopathological concept of chronic tonsillitis in children

The purpose of this study was to ascertain to what degree the clinical entity recurrent tonsillitis (RT) is associated with a histopathological pattern of chronic tonsillitis. Cases of idiopathic tonsillar hypertrophy (ITH) not associated with recurrent infections were used for comparison. We performed a histopathological study of 126 palatine tonsils of children (57 cases due to RT and 69 due to ITH). The following features were evaluated: cryptal reticulation, the relative amount of diffuse and follicular lymphoid tissues, the intensity of parenchymal fibrosis, the papillary arrangements of the epithelium, the amount of debris in the lumen of the crypts, and the presence of keratin cysts. There was no significant quantitative difference between the two groups (RT and ITH) and we did not find a histological distinctive pattern of RT or ITH. Recurrent infection in the tonsils in children is not associated with a histopathological pattern which could be termed chronic non-specific tonsillitis and is clearly distinguishable from idiopathic tonsillar hypertrophy.