Should routine histopathologıcal examination be performed on the tonsilectomy materials of adult patients?
Abstract
Objectives: Indications for tonsillectomy differs between adult and pediatric patients. This study aimed to retrospectively evaluate the histopathological results of adult patients, analyzing their frequency and clinical characteristics in conjuction with the literature.
Methods: This study retrospectively investigated the histopathological results of adult age group tonsil specimens applied over the last 15 years in our clinic. A total of 182 patient records were examinated. Patients under 18 and patients who could not be reached due to changes in Patient Information Manage-ment System were not included in the study.
Results: Malignancy was detected in 9 patients (4.9%). In 8 of these patients, tonsillectomy was perfor-med due to suspected malignancy. In one patient, an incidental malignancy was identified.
Conclusion: In adult cases undergoing tonsillectomy, routine histopathological examination is questi-onable if there are no indications of malignancy. This situation also contributes to a reduction in hospi-tal expenses. The incidence of incidental malignancy in our study is low, consistent with the literature. We consider histopathological examination essential for the diagnosis of theese patients.
Keywords
References
- 1. Hajiioannou J, Tsiouvaka S, Exarchos S, et al. Histo-pathologic examination of routine tonsillectomies in times of Greek austerity. Necessity or luxury? A retros-pective study of 823 patients. Clin Otolaryngol. 2014;39(4):235-237. doi:10.1111/coa.12257
- 2. Rokkjaer MS, Klug TE. Malignancy in routine tonsil-lectomy specimens: a systematic literature review. Eur Arch Otorhinolaryngol. 2014;271(11):2851-2861. doi:10.1007/s00405-014-2902-0
- 3. Brodsky L, Moore L, Stanievich JF. A comparison of tonsillar size and oropharyngeal dimensions in children with obstructive adenotonsillar hypertrophy. Int J Pedi-atr Otorhinolaryngol. 1987;13(2):149-156. doi:10.1016/0165-5876(87)90091-7
- 4. Erdag TK, Ecevit MC, Guneri EA, Dogan E, Ikiz AO, Sutay S. Pathologic evaluation of routine tonsillectomy and adenoidectomy specimens in the pediatric popula-tion: is it really necessary?. Int J Pediatr Otorhino-laryngol. 2005;69(10):1321-1325. doi:10.1016/j.ijporl.2005.05.005
- 5. Schrock A, Jakob M, Send T, Heukamp L, Bucheler M, Bootz F. Histologie nach Tonsillektomie? [Histology after tonsillectomy?]. HNO. 2009;57(4):351-357. doi:10.1007/s00106-009-1889-0
- 6. Reiter ER, Randolph GW, Pilch BZ. Microscopic detec-tion of occult malignancy in the adult ton-sil. Otolaryngol Head Neck Surg. 1999;120(2):190-194. doi:10.1016/S0194-5998(99)70405-5
- 7. Ridgway D, Wolff LJ, Neerhout RC, Tilford DL. Un-suspected non-Hodgkin's lymphoma of the tonsils and adenoids in children. Pediatrics. 1987;79(3):399-402.
- 8. Cinar F. Significance of asymptomatic tonsil asym-metry. Otolaryngol Head Neck Surg. 2004;131(1):101-103. doi:10.1016/j.otohns.2004.02.004
- 9. Syme N, Brettfeld S, Dorneden A, et al. Occult Malig-nancy in Adult Tonsillectomy for Benign Indication. Ann Otol Rhinol Laryngol. 2021;130(4):356-362. doi:10.1177/0003489420952474
- 10Williams MD, Brown HM. The adequacy of gross pathological examination of routine tonsils and adenoids in patients 21 years old and younger. Hum Pathol. 2003;34(10):1053-1057. doi:10.1053/s0046-8177(03)00408-8
- 11. Chow W, Rotenberg BW. Discontinuing routine histopathological analysis after adult tonsillectomy for benign indication. Laryngoscope. 2015;125(7):1595-1599. doi:10.1002/lary.25152
Abstract
Amaç: Erişkin ve çocuk hastalarda tonsilektomi endikasyonlarının dağılımı farklıdır. Bu çalışmada erişkin hastaların histopatolojik sonuçları retrospektif olarak değerlendirilerek sıklığı ve klinik özellik-leri literatür eşliğinde incelenmesi amaçlandı.
Yöntem: Retrospektif olarak son 15 yılda kliniğimizde erişkin yaş grubuna ait tonsil örneklerinin his-topatolojik sonuçları incelendi. Toplam 182 hasta kaydı incelendi. 18 yaşından küçük hastalar ve Hasta Bilgi Yönetim Sistemi (HBYS) değişikliği sebebiyle sonuçlarına ulaşılamayan hastalar çalışmaya dahil edilmedi.
Bulgular: Toplam 9 hastada (%4,9) malignite saptandı. Bu hastaların 8’inde tonsilektomi, malignite şüphesi nedeniyle gerçekleştirilmişti. Bir hastada ise insidental malignite tespit edildi.
Sonuç: Tonsilektomi yapılacak erişkin olgularda malignite ihtimali açısından endikasyon yoksa histo-patolojik inceleme yapılması tartışmalıdır. Bu durum hastane maliyetini de azaltmaktadır. İnsidental malignite insidansı, çalışmamızda literatürle uyumlu olarak düşüktür. Bu hastaların tanı alabilmesi için histopatolojik incelemenin gerekli olduğunu düşünüyoruz.
Keywords
References
- 1. Hajiioannou J, Tsiouvaka S, Exarchos S, et al. Histo-pathologic examination of routine tonsillectomies in times of Greek austerity. Necessity or luxury? A retros-pective study of 823 patients. Clin Otolaryngol. 2014;39(4):235-237. doi:10.1111/coa.12257
- 2. Rokkjaer MS, Klug TE. Malignancy in routine tonsil-lectomy specimens: a systematic literature review. Eur Arch Otorhinolaryngol. 2014;271(11):2851-2861. doi:10.1007/s00405-014-2902-0
- 3. Brodsky L, Moore L, Stanievich JF. A comparison of tonsillar size and oropharyngeal dimensions in children with obstructive adenotonsillar hypertrophy. Int J Pedi-atr Otorhinolaryngol. 1987;13(2):149-156. doi:10.1016/0165-5876(87)90091-7
- 4. Erdag TK, Ecevit MC, Guneri EA, Dogan E, Ikiz AO, Sutay S. Pathologic evaluation of routine tonsillectomy and adenoidectomy specimens in the pediatric popula-tion: is it really necessary?. Int J Pediatr Otorhino-laryngol. 2005;69(10):1321-1325. doi:10.1016/j.ijporl.2005.05.005
- 5. Schrock A, Jakob M, Send T, Heukamp L, Bucheler M, Bootz F. Histologie nach Tonsillektomie? [Histology after tonsillectomy?]. HNO. 2009;57(4):351-357. doi:10.1007/s00106-009-1889-0
- 6. Reiter ER, Randolph GW, Pilch BZ. Microscopic detec-tion of occult malignancy in the adult ton-sil. Otolaryngol Head Neck Surg. 1999;120(2):190-194. doi:10.1016/S0194-5998(99)70405-5
- 7. Ridgway D, Wolff LJ, Neerhout RC, Tilford DL. Un-suspected non-Hodgkin's lymphoma of the tonsils and adenoids in children. Pediatrics. 1987;79(3):399-402.
- 8. Cinar F. Significance of asymptomatic tonsil asym-metry. Otolaryngol Head Neck Surg. 2004;131(1):101-103. doi:10.1016/j.otohns.2004.02.004
- 9. Syme N, Brettfeld S, Dorneden A, et al. Occult Malig-nancy in Adult Tonsillectomy for Benign Indication. Ann Otol Rhinol Laryngol. 2021;130(4):356-362. doi:10.1177/0003489420952474
- 10Williams MD, Brown HM. The adequacy of gross pathological examination of routine tonsils and adenoids in patients 21 years old and younger. Hum Pathol. 2003;34(10):1053-1057. doi:10.1053/s0046-8177(03)00408-8
- 11. Chow W, Rotenberg BW. Discontinuing routine histopathological analysis after adult tonsillectomy for benign indication. Laryngoscope. 2015;125(7):1595-1599. doi:10.1002/lary.25152
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Otorhinolaryngology |
| Journal Section | Articles |
| Authors | |
| Publication Date | May 29, 2025 |
| Submission Date | November 27, 2024 |
| Acceptance Date | March 5, 2025 |
| Published in Issue | Year 2025 Volume: 6 Issue: 2 |
Cite
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.