Clinical significance and diagnostic approach for paediatric unilateral tonsillar enlargement: insights from a retrospective analysis.

IF 1.1 4区医学 Q3 SURGERY

Annals of the Royal College of Surgeons of England Pub Date : 2025-04-03 DOI:10.1308/rcsann.2024.0113

A Nelson, I Bujoreanu, J Gaskin

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引用次数: 0

Abstract

Background: One of the debated indications for paediatric tonsillectomy is unilateral tonsillar enlargement (UTE). The majority of UTE is innocuous in nature; however, concerns exist around a diagnosis of lymphoma, typically found in the presence of other symptoms.

Methods: A retrospective case series analysis of all paediatric tonsillectomy specimens at Bristol Children's Hospital between January 2006 and January 2023 was undertaken.

Results: Four (1.3%) lymphoma diagnoses were identified from the 319 patients who underwent tonsillectomy for UTE. Three patients had localised disease and one patient had systemic infiltration of disease. All patients presented with other signs of malignancy including cervical lymphadenopathy (100%), alteration of appearance of tonsil including colour or visible lesion (75%), snoring (75%), dysphagia (50%), recurrent fever (25%) and weight loss (25%).

Conclusions: We recommend active monitoring of asymptomatic isolated UTE. Diagnostic tonsillectomy should be performed in patients with UTE and cervical lymphadenopathy and/or constitutional symptoms and/or altered tonsillar appearance.

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小儿单侧扁桃体肿大的临床意义和诊断方法：回顾性分析的见解。

背景：儿童扁桃体切除术的适应症之一是单侧扁桃体肿大（UTE）。大多数UTE本质上是无害的；然而，对淋巴瘤的诊断存在担忧，通常在出现其他症状时发现。方法：回顾性分析布里斯托尔儿童医院2006年1月至2023年1月间所有儿童扁桃体切除术标本。结果：319例因UTE行扁桃体切除术的患者中有4例（1.3%）被诊断为淋巴瘤。3例为局部病变，1例为全身浸润。所有患者均出现其他恶性肿瘤征象，包括宫颈淋巴结病（100%）、扁桃体外观改变(包括颜色或可见病变（75%）、打鼾（75%）、吞咽困难（50%）、反复发热（25%）和体重减轻（25%）。结论：我们建议积极监测无症状孤立性UTE。诊断性扁桃体切除术应在患有UTE和宫颈淋巴结病和/或体质症状和/或扁桃体外观改变的患者中进行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Annals of the Royal College of Surgeons of England Medicine-Surgery

CiteScore

2.40

自引率

0.00%

发文量

316

期刊介绍： The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.