Objectives: To discuss a case of primary melanoma of the palatine tonsil in a 57-year-old man presented with a dark, pigmented tonsillar mass initially managed as a case of arterio-venous malformation, and review the literature on its presentation, diagnosis, management and outcomes. : Methods Design: Case Report Setting: Tertiary Government Training Hospital Patient: One Results: A 57-year-old man presented with a pigmented, bluish-black mass (7.2 cm) on the right tonsillar area with dysphagia and odynophagia. A CT scan interpretation considered large tonsillar malignancy, right with infiltrations of the soft palate, lingual tonsils and pre-epiglottic space. The initial impression was an arteriovenous malformation and preoperative arterial embolization was followed by a tonsillectomy. The final biopsy result was mucosal melanoma. Refusing further treatment, he expired nine months later in the emergency room, after presenting with decreasing sensorium and desaturations, jaundice and abdominal distension. Conclusion To the best of our knowledge, this is the first reported case of tonsillar melanoma in the Philippines. Primary tonsillar melanoma is rare but its diagnosis is still possible (although it is usually diagnosed in advanced stages). Despite improvement in surgical techniques and adjuvant therapies, its prognosis remains poor. Regular oral cavity screening may help in early detection.
Palatine Tonsil ; Melanoma

Humans ; Child ; Adenoids/surgery* ; Palatine Tonsil/surgery* ; Adenoidectomy ; Hypertrophy/surgery* ; Tonsillectomy

Objective:To explore the effects of mouth opening breathing for different reasons on children's maxillofacial development. Methods:One hundred and fifty-one children were selected as the research objects of this experiment. They were divided into 49 cases of adenoid hypertrophy group（group A）, 52 cases of tonsillar hypertrophy group（group B） and 50 cases of adenoid with tonsillar hypertrophy group（Group C）. Healthy children in the same period were selected as the control group, a total of 45 cases. The reflex nasopharyngeal measurement parameters, facial development indexes and cephalometric parameters of group A, group B, group C and control group were analyzed, and the incidence of Angle ClassⅡand Angle Class Ⅲ in group A, group B and group C were studied. Results:Compared with the control group, the reflex nasopharyngeal measurement parameters in group A, group B and group C was significantly different（P<0.05）, and the cephalometric parameters changed with variation in groups（P<0.05）. The incidence of Angle Class Ⅱ facial pattern in group A and group C was higher, but the incidence of Angle Class Ⅲ facial pattern in group B and group C was higher（P<0.05）. Conclusion:Adenoid hypertrophy leads to mandibular retraction; tonsil hypertrophy leads to anterior mandibular arch; adenoid hypertrophy and tonsil hypertrophy are easy to lead to clockwise rotation of the mandible. In clinical practice, to avoid children's uncoordinated maxillofacial development, we should correct the maxillofacial situation of children as soon as possible.
Child ; Humans ; Maxillofacial Development ; Malocclusion, Angle Class III/complications* ; Nasopharynx ; Adenoids ; Palatine Tonsil ; Mouth Breathing/etiology* ; Hypertrophy/complications* ; Mouth

Objective:To investigate the changes of inflammation and immune function in children with chronic tonsillitis after tonsillotomy. Methods:Prospectively collected 60 children with obstructive sleep apnea （OSA） diagnosed as chronic tonsillitis with adenoids and tonsillar hypertrophy from January to June 2021. Two groups were divided, the experimental group （n=30） underwent bilateral partial tonsillectomy + adenoidectomy by hypothermia plasma ablation, and the control group （n=30） underwent adenoidectomy by using the same hypothermia plasma ablation method. The number of tonsillitis attacks before surgery and within one year after surgery was recorded, and the serum immunoglobulin IgM, IgG, IgA, complement C3 and complement C4 levels before operation, one month and three months after operation were measured. Results:The number of tonsillitis attacks in the experimental group and the control group at one year after surgery was lower than that before surgery（P<0.05）; The number of inflammatory attacks in the experimental group was （0.50±0.63） times/year, which was lower than that of （1.33±0.80） times/year in the control group. There was no significant difference in the five immunization results of the two groups at one month and three months after operation compared with before operation, and there was also no significant difference between the experimental and the control groups. Conclusion:Partial tonsillectomy can be applied to children with chronic tonsillitis, which can effectively reduce the number of tonsillitis attacks and has no effect on the immune function of children.
Child ; Humans ; Tonsillectomy/methods* ; Hypothermia ; Tonsillitis/surgery* ; Adenoidectomy ; Palatine Tonsil/surgery* ; Inflammation ; Chronic Disease ; Immunity

Objective: To investigate the possible pathophysiological mechanism of laryngopharyngeal reflux (LPR) in the development of lingual tonsil hypertrophy (LTH). Methods: The lingual tonsil tissues were collected from 73 patients [48 males and 25 females, aged from 24 to 76 (52.86±12.04) years] who underwent surgery for laryngopharyngeal diseases at the Department of Otolaryngology and Head and Neck Surgery, Southern Hospital of Southern Medical University from October 2019 to December 2020, and the lingual tonsil grade (LTG), reflux symptom index (RSI) and reflux finding score (RFS) were assessed. The expression of pepsin in LTH was detected by immunohistochemistry. The coexpression of pepsin and macrophages were detected by immunohistofluorescence. In vitro, cytological experiments and pathway assays were performed on macrophages stimulated by pepsin. Pathway alterations of macrophages in pepsin-positive high-grade LTH were detected by double-fluorescence immunohistochemistry. Data were analyzed by SPSS 20.0 software. Results: There were 44 clinically significant LPRD patients with LTG 3 and 4, and the pepsin positive rate was 88.6% (39/44). While, the pepsin positive rate of LTG 1 and 2 was 48.3% (14/29). LTG was significantly positively correlated with RFS/RSI positive rate(χ²=23.01/19.62, P<0.001/0.001; r=0.54/0.51, P<0.001/0.001) and pepsin tissue staining intensity (H=21.58, P<0.001; r=0.53, P<0.001), respectively. Pepsin and macrophages were clearly colocalized in high grade LTH. In vitro, pepsin promoted macrophage proliferation (P<0.05) and production of IL-6/IL-8 (P<0.05). Pepsin significantly up-regulated the p38/JNK MAPK pathway in macrophages (P<0.05). Pepsin up-regulated the expression of IL-6 and IL-8 of macrophages by activating the p38 MAPK pathway (P<0.05), and up-regulated the expression of IL-8 by activating the JNK pathway (P<0.05). The p38/JNK MAPK pathways were highly expressed in macrophages of pepsin-positive LTH (P<0.05). Conclusions: LPR is an important pathogenic factor in LTH. Macrophages may mediate pepsin-induced inflammation and the pathogenesis of LTH.
Female ; Male ; Humans ; Palatine Tonsil ; Pepsin A ; Interleukin-6 ; Interleukin-8 ; Hypertrophy ; Macrophages ; Laryngopharyngeal Reflux

Objective: To investigate the prevalence of tonsil hypertrophy in patients with different sagittal skeletal craniofacial patterns, as well as the correlation between tonsil hypertrophy and the type of skeletal pattern. Methods: Lateral cephalograms of patients who visited the Department of Orthodontics Division 1, School of Stomatology, Wuhan University during January to August, 2019 were retrospectively collected. Patients (children: age≥6 and ≤12 year; adults: age≥18 year) were divided into three groups according to the ANB (subspinale-nasion-supramental) angle: the skeletal class Ⅰ group (0°≤ANB≤4°), skeletal class Ⅱ group (ANB>4°) and skeletal class Ⅲ group (ANB<0°). Tonsil hypertrophy was diagnosed with lateral cephalogram by two specifically trained orthodontists independently, according to the Baroni's method. The between-group differences in tonsil hypertrophy prevalence were analyzed using chi-square tests with Bonferroni correction (α=0.017). Results: A total of 1 776 patients (593 children and 1 183 adults) were included, among which 672 (37.8%) were with class Ⅰ, 849 (47.8%) with class Ⅱ, and 255 (14.4%) with class Ⅲ skeletal pattern. The prevalence of tonsil hypertrophy in children was 66.3% (393/593). The proportion of children with tonsil hypertrophy in class Ⅲ group [87.0% (60/69)] were significantly higher than that in class Ⅰ [65.6% (145/221), χ²=11.56, P<0.017] and class Ⅱ [62.0% (188/303), χ²=15.69, P<0.017] groups. The prevalence of tonsil hypertrophy in adults was 23.2% (275/1 183). The proportion of adults with tonsil hypertrophy in class Ⅲ group [42.5% (79/186)] was significantly higher than that in class Ⅰ [19.1% (86/451), χ²=36.50, P<0.017] and class Ⅱ [20.2% (110/546), χ²=35.00, P<0.017] groups. However, there was no significant difference in the prevalence of tonsil hypertrophy between class Ⅰ and class Ⅱ groups for both children (χ²=0.70, P>0.017) and adults (χ²=0.18, P>0.017). Conclusions: The prevalence of tonsil hypertrophy in skeletal class Ⅲ patients was significantly higher than that in patients with skeletal class Ⅰ and Ⅱmalocclusion. Tonsil hypertrophy could be an important risk factor for skeletal class Ⅲ patients.
Adolescent ; Adult ; Cephalometry/methods* ; Child ; Humans ; Hypertrophy ; Malocclusion ; Palatine Tonsil ; Retrospective Studies

Humans ; Malacoplakia/diagnosis* ; Palatine Tonsil

Carcinoma, Hepatocellular ; Hemangiosarcoma ; Humans ; Liver Neoplasms ; Lung Neoplasms ; Palatine Tonsil

Adenoidectomy ; Adenoids ; Humans ; Hypertrophy ; Microbiota ; Palatine Tonsil ; Tonsillectomy

OBJECTIVE: To investigate the clinical manifestation, immunophenotypes and prognostic factors of patients with primary tonsil afftive large B cell lymphoma ( PT-DLBCL ). METHODS: The clinical data including clinical characterstics, typing, staging, treatment efficacy and prognostic factors of PT-DLBCL patients were collected and analyzed restrospectively. RESULTS: Out of 36 cases with the detinite cell origin, 24 cases (66.7%) were detecmined as the type of germinal center B-cell (GCB) and 12 cases (33.3%) was non-germinal center B-cell (non-GCB), 15 (40.5%) out of 37 cases were in Ann Arbor stage Ⅰ, and 22 (59.5%) in stage Ⅱ. With the median follow-up of 44 (10-101) months, 2 cases (5.4%) failed to be followed-up, after treatment for 6 (3-8) cycles 35 patients were evaluated. Among them 26 cases (74.3%) reached to complete remission (CR), 8 cases (22.9%) to partial remission ( PR ), and 1 (2.8%) to stable disease (SD). Both the 3 years and 5 years progression-free survival ( PFS ) were 82.5%, and both 3 and 5 years overall survival (OS) were 95.5%. 5 cases (13.5%) received radiotherapy. The patients aged＞60 ( P＜0.05 ) or aged＞70 (P＜0.05) had shorter PFS than younger patients. The patients with increased lactic dehydrogenase ( LDH ) level (P＜0.01) and without rituximab (R) (P＜0.05) in the treatment regimen had relatively short OS. CONCLUSION The patients sensitive to chemotherapy and/or radiotherapy have a good prognosis. Most of the patients can obtain long-term survival after treatment. The effect of combined immunotherapy are better than that of the simple chemotherapy.
Aged ; Humans ; Lymphoma, Large B-Cell, Diffuse ; Middle Aged ; Palatine Tonsil ; Prognosis ; Tonsillar Neoplasms