A Comparative Clinicopathologic Analysis of Tonsillectomy and Adenoidectomy Cases: A Retrospective Study

Year 2020, , 186 - 193, 02.10.2020

Büşra Yaprak Bayrak , Fatih Mutlu

https://doi.org/10.30934/kusbed.693112

Abstract

Objective: In this retrospective study, we aimed to determine the rate of malignancy detected in patients who underwent tonsillectomy, adenoidectomy or adenotonsillectomy in our clinic, and to correlate the clinical findings of adults and children by giving their histopathological analysis.
Methods: Histopathological specimens of 288 adenoidectomy, tonsillectomy and adenotonsillectomy cases operated in our clinic between years of 2017-2019 were collected retrospectively and re-evaluated with clinical data.
Results: Malignancy was suspected clinically in 12.8% (n=37) of all cases, and most of them (n=33) were in tonsillectomy group. Although reactive lymphoid hyperplasia was a common diagnosis among all cases (92.7%), 11 (3.8%) patients were diagnosed as a benign/malign neoplasm. The malignancy rate among all cases was found to be 2.1% (6/288), among tonsillectomy cases was 8.8% (6/68). All malignancies were detected among tonsillectomy cases in adults.
Conclusion: This retrospective analysis of adenotonsillar surgeries correlated with histopathological findings showed that the incidence of tonsil neoplasm in adult patients is higher than the previously published data. In the tonsillar tissues presenting with a surgical indication of clinical suspicion for malignancy such as ulceration and necrosis, and of enlargement of tonsils, a histopathological evaluation are obviously warranted. These results are in agreement with that a routine histopathological examination is needed to be regardless of the clinically presence of high malignancy suspicion prior to tonsillectomy in adults.

An Erratum to this article was published on 05 January 2021. https://dergipark.org.tr/en/pub/kusbed/issue/59476/854715 

Keywords

adenoidectomy, neoplasm, pathology, tonsillectomy

Supporting Institution

-

Project Number

GOKAEK-2020 / 2.04 - 2020/8

Thanks

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Tonsillektomi ve Adenoidektomi Yapılan Olguların Retrospektif İncelenmesi ve Karşılaştırmalı Klinikopatolojik Analizi

Abstract

Amaç: Bu retrospektif çalışmayla, kliniğimizde tonsillektomi, adenoidektomi veya adenotonsillektomi uygulanan hastalarda malignite oranını saptamayı, yetişkinlerin ve çocukların histopatolojik analizlerini yaparak klinik bulgularıyla ilişkilendirmeyi amaçladık.
Yöntem: 2017-2019 yılları arasında kliniğimizde opere edilen 288 adenoidektomi, tonsillektomi ve adenotonsillektomi olgusunun histopatolojik örnekleri, retrospektif olarak toplandı ve klinik verilerle tekrar değerlendirildi.
Bulgular: Tüm olguların %12,8'inde (n=37) malignite şüphesi vardı ve bunların çoğu (n=33) tonsillektomi grubunda idi. Reaktif lenfoid hiperplazi, tüm olgularda (%92,7) en sık tanı olmasına rağmen, 11 (%3,8) olguya benign / malign neoplazm tanısı konuldu. Tüm olgularda malignite oranı %2,1 (6/288) iken, tonsillektomi yapılan olgularda %8,8 (6/68) bulundu. Tüm maligniteler, sadece yetişkinlerde, tonsillektomi yapılan olgularda saptandı.
Sonuç: Adenotonsiller ameliyatların histopatolojik raporlarla korelasyonu yapılan bu retrospektif analiz, erişkin hastalarda, tonsil neoplazm insidansının, daha önce yayınlanan verilerden daha yüksek olduğunu göstermiştir. Ülserasyon, nekroz, tonsiller büyüme gibiklinik malignite şüpheli, cerrahi endikasyonu olan tonsil dokularında, histopatolojik değerlendirme yapılması gerekliliği açıkça görülmektedir. Bu sonuçlar, yetişkinlerde, tonsillektomi öncesi, klinik olarak yüksek malignite şüphesi olmasına bakılmaksızın, rutin bir histopatolojik incelemeye ihtiyaç duyulduğu gerçeğiyle uyumludur.

Bu makale için 05-01-2021 tarihinde bir düzeltme yayınlandı. https://dergipark.org.tr/tr/pub/kusbed/issue/59476/854715 

Keywords

adenoidektomi, neoplazm, patoloji, tonsillektomi

Project Number

GOKAEK-2020 / 2.04 - 2020/8

References

• Tan GC, Stalling M, Al-Rawabdeh S, Kahwash BM, Alkhoury RF, Kahwash SB. The spectrum of pathological findings of tonsils in children: A clinicopathological review. Malays J Pathol. 2018;40(1):11-26. Review. PubMed PMID: 29704380.
• Campo E, Chott A, Kinney MC, et al. Update on extranodal lymphomas. Conclusions of the Workshop held by the EAHP and the SH in Thessaloniki, Greece. Histopathology. 2006;48(5):481-504. doi: 10.1111/j.1365-2559.2006.02369.x
• Verma SP, Stoddard T, Gonzalez-Gomez I, Koempel JA. Histologic analysis of pediatric tonsil and adenoid specimens: is it really necessary? Int J Pediatr Otorhinolaryngol. 2009;71:547–50. doi: 10.1016/j.ijporl.2008.11.001
• Dell'Aringa AR, Juares AJ, Melo Cd, Nardi JC, Kobari K, Perches Filho RM. Histological analysis of tonsillectomy and adenoidectomy specimens--January 2001 to May 2003. Braz J Otorhinolaryngol. 2005;71(1):18-22. doi:10.1016/s1808-8694(15)31279-9
• Genden EM, Ferlito A, Scully C, Shaha AR, Higgins K, Rinaldo A. Current management of tonsillar cancer. Oral Oncol. 2003;39(4):337-42. doi: 10.1016/s1368-8375(02)00085-4
• Bizzell JG, Richter GT, Bower CM, Woods GL, Nolder AR. Routine pathologic examination of tonsillectomy specimens: A 10-year experience at a tertiary care children’s hospital. Int J Pediatr Otorhinolaryngol. 2017;102:86-9. doi: 10.1016/j.ijporl.2017.09.012
• Koç S, Uysal IO, Yaman H, Eyibilen A. Histopathologic examination of routine tonsil and adenoid specimens: is it a necessary approach?. Kulak Burun Bogaz Ihtis Derg. 2012;22(2):87-90. doi:10.5606/kbbihtisas.2012.016
• Lifshitz G, Gruber M, Ronen O. Occult malignancy in pediatric tonsil and adenoid surgeries - A national survey. Int J Pediatr Otorhinolaryngol. 2019;117:171-4. doi: 10.1016/j.ijporl.2018.11.031
• Brodsky L. Modern assessment of tonsils and adenoids. Pediatr Clinic N Am. 1989; 36: 1551-69. doi: 10.1016/s0031-3955(16)36806-7
• Cho JH, Lee DH, Lee NS, Won YS, Yoon HR, Suh BD. Size assessment of adenoid and nasopharyngeal airway by acoustic rhinometry in children. J Laryngol Otol. 1999;113(10):899-905. doi: 10.1017/s0022215100145530
• Aksakal C, Müslehiddinoğlu A. Comparison of Routine Histopathological Examination Results in Children and Adults After Tonsillectomy and/or Adenoidectomy. Turk Arch Otorhinolaryngol. 2018;56(3):170–3. doi: 10.5152/tao.2018.3391
• Younis RT, Hesse SV, Anand VK. Evaluation of the utility and cost-effectiveness of obtaining histopathologic diagnosis on all routine tonsillectomy specimens. Laryngoscope. 2001; 111: 2166-9. doi: 10.1097/00005537-200112000-00017
• Papouliakos S, Karkos PD, Korres G, Karatzias G, Sastry A, Riga M. Comparison of clinical and histopathological evaluation of tonsils in pediatric and adult patients. Eur Arch Otorhinolaryngol. 2009;266:1309-13. doi: 10.1007/s00405-008-0869-4
• Faramarzi A, Ashraf MJ, Hashemi B, et al. Histopathological screening of tonsillectomy and/or adenoidectomy specimens: a report from southern Iran. Int J Pediatr Otorhinolaryngol. 2009;73:1576–9. doi: 10.1016/j.ijporl.2009.08.008.
• Randall DA, Martin PJ, Thompson LDR. Routine histologic examination is unnecessary for tonsillectomy or adenoidectomy. Laryngoscope. 2007;117:1600-4. doi: 10.1097/MLG.0b013e318093ee4e
• Booth CL, Wang J. Occult hematologic malignancy in routine tonsillectomy specimens: a single institutional experience and review of the literature. Am J Clin Pathol. 2013;140:807-12. doi: 10.1309/AJCPCM7LN4QEZPOQ
• Williams MD, Brown HM. The adequacy of gross pathological examination of routine tonsils and adenoids in patients 21 years old and younger. Hum Pathol. 2003;34:1053-7. doi: 10.1053/s0046-8177(03)00408-8
• Garavello W, Romagnoli M, Sordo L, Spreafico R, Gaini RM. Incidence of unexpected malignancies in routine tonsillectomy specimens in children. Laryngoscope. 2004;114:1103-5. doi: 10.1097/00005537-200406000-00027
• Kepekçi AH, Balıkçı HH. Is Routine Histopathologic Examination Necessary Following Tonsillectomy and/or Adenoidectomy Procedures in Pediatric Patients? J Craniofac Surg. 2017;28:91-3. doi: 10.1097/SCS.0000000000003278