Atypical lymphoid hyperplasia in a patient undergoing tonsillectomy for severe obstructive sleep apnea

Int J Pediatr Otorhinolaryngol. 2020 Jul:134:110066. doi: 10.1016/j.ijporl.2020.110066. Epub 2020 Apr 24.

Abstract

Tonsillectomy is a common procedure in the pediatric population, with subsequent microscopic examination of the specimen for cancer and other rare diagnoses occurring routinely. A 17 year-old female with a history of autoimmune vasculitis underwent adenotonsillectomy for severe obstructive sleep apnea. Pathology demonstrated small, medium and large lymphocytes and plasma cells obscuring the lymphoid follicles and germinal centers, with few Epstein-Barr virus positive lymphocytes. Tingible body macrophages were seen in the vaguely nodular areas. This reactive histologic pattern represents an atypical lymphoproliferative disorder never before documented in tonsils. Histopathologic images will be shown.

Keywords: Adenotonsillectomy; Autoimmune disease; Hyperplasia; Lymphoproliferative disorder; Obstructive sleep apnea; Pathology.

Publication types

  • Case Reports

MeSH terms

  • Adenoidectomy
  • Adolescent
  • Female
  • Humans
  • Hyperplasia
  • Lymphocytes / pathology
  • Lymphoproliferative Disorders / pathology*
  • Palatine Tonsil / immunology
  • Palatine Tonsil / pathology*
  • Sleep Apnea, Obstructive / surgery*
  • Tonsillectomy*