Immunoglobulin G4-related sclerosing disease (IgG4-SD) is currently recognized as a distinct systemic disease involving various organs. We reported the imaging findings of a case of pathologically confirmed IgG4-SD involving bilateral palatine tonsils. CT and MRI showed diffuse enlargement of both palatine tonsils with homogeneous contrast enhancement. Focal contour bulging was noted in the right palatine tonsil. Lesions appeared as isointense on T1-weighted and slightly hyperintense on T2-weighted MRI images, as compared with muscle. The T2-weighted MRI image showed a striated pattern in both tonsils. Despite its rare occurrence, IgG4-SD should be included in the differential diagnoses of patients with symptomatic bilateral tonsillar hypertrophy that is non-responsive to medication.
Diagnosis, Differential ; Female ; Humans ; Hypertrophy/pathology ; Immunoglobulin G/*immunology ; Magnetic Resonance Imaging/methods ; Middle Aged ; Palatine Tonsil/*pathology ; Retrospective Studies ; Sclerosis/diagnosis/*pathology

The primary etiopathology of pediatric OSAHS includes tonsil or adenoid hypertrophy. Severe OSAHS contributes to or aggravates thoracic deformity, which is rarely reported. In the current report, This children sleep snoring more than 4 years, increasing with thoracic severe depression during sleep 2 days. Clinical examination indicated tonsil and adenoid hypertrophy, and polysomnography revealed OSAHS . The symptoms of OSAHS and severe inhalation-related sternum depression disappeared rapidly after tonsillectomy. Our findings indicated that OSAHS were the major causes underlying funnel chest in children. The rarity of the incidence may result in missed diagnosis or misdiagnosis. Polysomnography was recommended for the child diagnosed with funnel chest accompanied by upper airway stenosis.
Adenoids ; pathology ; Child ; Funnel Chest ; diagnosis ; Humans ; Hypertrophy ; Palatine Tonsil ; pathology ; Polysomnography ; Sleep Apnea, Obstructive ; diagnosis ; Snoring ; Tonsillectomy

OBJECTIVE: To explore the effects of pure adenoidectomy,adenoidectomy with partial tonsillectomy,and adenoidectomy with total tonsillectomy on humoral and cellular immunity of children with OSAHS. METHOD: The children with OSAHS diagnosed by polysomnography were divided into pure adenoidectomy group(group A),adenoidectomy with partial tonsillectomy group(group B), and adenoidectomy with total tonsillectomy(group C), and there were 50 cases in each group. The serum IgG, IgA, IgM level and peripheral blood T cell subgroup per-centage were detected at 6 months preoperatively and postoperatively. Tonsil grading and polysomnography wereconducted, recording symptoms improvement situation at postoperative 6 months. RESULT: There was no statisticallysignificant difference compared with preoperative(P>0. 05) in humoral immunity and cellular immunity index ofpostoperative 6 months. There was no significani difference(P>C. 05) in curative effect among three groups in the 6th month post-operatively. CONCLUSION All of these three surgical procedures had no obvious effect on humoral orcellular immune function in children, and could effectively treat children OSAHS.
Adenoidectomy ; Antibodies ; blood ; Child ; Humans ; Immunity, Cellular ; Immunity, Humoral ; Palatine Tonsil ; pathology ; Polysomnography ; Postoperative Period ; Sleep Apnea, Obstructive ; immunology ; surgery ; T-Lymphocyte Subsets ; cytology ; Tonsillectomy

OBJECTIVETo evaluate the sleep architecture and hypoxia and clinical features of habitual snoring children with an obstructive sleep apnea-hypopnea index (OAHI) 1 to 5.

METHODThe polysomnographic data of 267 children aged from 2 to 16 years with habitual snoring were analyzed retrospectively, and the clinical features were analyzed in 108 of the children. The recruited children were divided into primary snoring group (PS group, OAHI≤1), obstructive sleep apnea hypopnea syndrome (OSAHS) group (15 or dostructive apnea index>1, LSpO2<0.92).

RESULTThe oxygen desaturation index of the intermediate OSAHS group (3.8±0.4) was significantly higher than that of PS group (1.6±0.1) (χ2=34.5, P<0.01). The LSpO2 of intermediate OSAHS group was significantly lower than that of PS group (89(87,91) vs. 93(91,94), χ2=40.2, P<0.01). Comparing to the PS group, the non-rapid eye movement 1 ratio (N1%) was significantly higher (19.0±1.2 vs. 14.2±0.1, χ2=14.1, P<0.01), and the non-rapid eye movement 3 ratio (N3%) was significantly lower (24.4±1.0 vs. 29.0±1.1, P<0.01) in the intermediate OSAHS group. The pediatric questionnaire score intermediate OSAHS group was higher than PS (0.41±0.19 vs. 0.28±0.14, χ2=8.52, P=0.01). The adenoids-nasopharynx ratio was higher than that of PS group (0.70±0.07 vs. 0.62±0.10, χ2=8.96, P=0.01). The hypertrophy of tonsil was higher than PS group (2(1,2) vs. 1(1,2), χ2=7.95, P<0.05).

CONCLUSIONHypoxia and abnormal sleep structure are present in HS children with an OAHI of 1 to 5, and they also have the clinical features of OSAHS.

Adenoids ; pathology ; Adolescent ; Child ; Child, Preschool ; Humans ; Hypertrophy ; Hypoxia ; Oxygen ; blood ; Palatine Tonsil ; pathology ; Polysomnography ; Retrospective Studies ; Sleep ; Sleep Apnea, Obstructive ; diagnosis ; Snoring ; Surveys and Questionnaires

The clinical manifestation included snoring and mouth breathing for 2 years, repeated coughing and shortness of breath in action for more than 1 year. Physical examination of oral cavity showed tonsils were in grade III. The endoscopy showed 2/3 of postnaris were blocked by the adenoids. The preoperative ultrasonic cardiogram revealed the right atrial and right ventricular dilatation, pulmonary artery widened. The preoperative polysomnography (PSG) showed apnea-hypopnea index (AHI) was 28.5 events an hour, and the lowest oxygen saturation (LSaO2) was 39%. The patient was diagnosed as severe obstructive sleep apnea hypopnea syndrome with pulmonary hypertension. The postoperative PSG showed the AHI was 11.7 events an hour, and the LSaO2 was 86%. The ultrasonic cardiogram at 5 months after surgery didn't show any abnormalities.
Adenoids ; pathology ; Child ; Cough ; Humans ; Hypertension, Pulmonary ; complications ; diagnosis ; Palatine Tonsil ; pathology ; Polysomnography ; Sleep Apnea, Obstructive ; complications ; diagnosis ; Snoring

We describe a case of a 7-year-old child with Down syndrome who presented with loud snoring and cessation of breath during sleep and was found to have a large calculus (20 mm X 12 mm X 12 mm) in her left tonsil by CT scan for which tonsillectomy with adenoidectomy were done. This is one of the youngest reported cases in the literature.
Adenoidectomy ; Calculi ; complications ; surgery ; Child ; Female ; Humans ; Lymphatic Diseases ; Palatine Tonsil ; pathology ; Pharyngeal Diseases ; Sleep ; Snoring ; Tomography, X-Ray Computed ; Tonsillectomy

Patient, 30-year-old, male,was admitted to our hospital because of discontinuously spit fresh blood without any inducing factors for three days. In the course, the patient suffered mild dry sensation of pharyngeal, poor spirit condition, fatigue, poor sleep, poor appetite and was with black stool 2 times. Physical examination: T36. 6°C, R 21/min, P98/min, BP135/90 mmHg (1 mmHg = 0.133 kPa). Bilateral tonsils were III hypertrophy and with scar shape surfaces. The left tonsil's surface had longitudinal small blood vessels markedly dilated. His oropharynx, laryngopharynx and laryngeal did not be find any obvious bleeding sites. Laboratory findings: WBC 13.82 x 10(9)/L, N 0.8084, L 0.1632, Hb 81.00 g/L, HCT 25.20; PT 9.60 s, APTT 25.50 s, TT 15.80 s, FIB 1.900 g/L. After 3 hours of admission,the patient spit out fresh blood again,checked the body to see:the left peri-tonsil with fresh blood and found a slowly bleeding site at the 1/3 junction of the middle lower part of left tonsil's rear surface, the size was about 0.5 cm x 0.6 cm. We finally diagnosed spontaneous tonsillar hemorrhage and successfully managed with low-temperature radiofrequency technology.
Adult ; Catheter Ablation ; Hemorrhage ; therapy ; Humans ; Hypertrophy ; Hypopharynx ; Larynx ; Male ; Oropharynx ; Palatine Tonsil ; pathology ; Temperature

Follicular dendritic sarcoma is a rare and low-grade malignant soft tissue tumors , often occurs in the lymph nodes, we report a case of tonsil follicular dendritic sarcoma which occured after Non-Hodgkin's lymphoma had be cured. The chief complaint was oropharyngeal foreign body sensation with hemoptysis three years, found in the left neck mass increased with more than 4 months. The left side of the pharyngeal wall thickening and disappearance of parapharyngeal space with the surrounding lymph nodes extremely enlarged and integrated was demonstrated by the contrast-enhanced CT of neck. Finally,the pathological diagnosis was tonsil follicular dendritic sarcoma.
Female ; Humans ; Lymph Nodes ; pathology ; Lymphoma, Non-Hodgkin ; therapy ; Neck ; Oropharyngeal Neoplasms ; diagnostic imaging ; pathology ; Palatine Tonsil ; diagnostic imaging ; pathology ; Radiography ; Sarcoma ; diagnostic imaging ; pathology

OBJECTIVE: To investigate the relationship between obstructive sleep apnea hypopnea syndrome (OSAHS) and adenoid size as well as tonsil size in Children. METHOD: A total of 545 patients, 338 OSAHS patients (treated group) diagnosed by PSG and 207 patients with vocal cord nodules but symptoms of upper airway obstruction (control group), were enrolled from inpatient and outpatient between June, 2008 and October, 2010. The oropharynx and electron-nasopharyngolaryngoscopy examination records of the two groups were retrospectively analyzed. The patients in the treated group were also divided into mild group, moderate group and severe group according to obstructive apnea index (OAI) or AHI. SPSS 17.0 was used for statistical analysis. RESULT: In the treated group, 89.7% had grade III-V adenoid and 68.4% had grade III-IV tonsil, compared with 30.9% (adenoid) and 13.5% (tonsil) in the control group. The significant differences were found (all P < 0.01). The comparison between patients with different grades of adenoidal size and tonsil size in the treated group had indicated that patients with grade IV adenoid or grade IV tonsil have a higher risk of OSAHS than patients with grade III adenoid or grade III tonsil. In the treated group, the ratio of patients with different severity of adenoid or tonsil had increased with the severity of OSAHS (P < 0.01). This retrospective study had also found that most of the grading results from Electron-nasopharyngolaryngoscopy examination were consistent with that from oropharynx examination. 13 (37.1%) of 35 patients with grade I or II tonsil diagnosed by Oropharynx examination were considered as grade III by Electron-nasopharyngolaryngoscopy examination. CONCLUSION Adenoidal hypertrophy and tonsil hypertrophy are the risk factors for OSAHS in children. The risk of OSAHS and the severity of OSAHS are positively associated with the severity of adenoid and tonsil. The electron-nasopharyngolaryngoscopy examination is an important examination method for diagnosing OSAHS in children, as well as determination of tonsil size.
Adenoids ; pathology ; Adolescent ; Child ; Endoscopy ; methods ; Female ; Humans ; Hypertrophy ; complications ; pathology ; Laryngoscopy ; methods ; Male ; Organ Size ; Palatine Tonsil ; pathology ; Retrospective Studies ; Risk Factors ; Sleep Apnea, Obstructive ; classification ; etiology

OBJECTIVE: The aim of the present study was to evaluate the effects of radiofrequency coblation surgery for treatment of abnormal sensation of throat induced by the hypertrophy of lingual tonsil. METHOD: Three hundred and seven patients affected by abnormal sensation of throat induced by the hypertrophy of lingual tonsil were enrolled. Radiofrequency coblation was performed on all patients under nasal endoscopy. A comprehensive statistics were obtained from all the participants regarding the recovery of wound surface, postoperative pain, intra and postoperative bleeding and the effects of the procedure. RESULT: The VAS score of abnormal sensation of throat was reduced from (9.3 +/- 0.6) to (3.7 +/- 2.4) (P<0.05) after the operation. 84.4% of the abnormal sensation dis appeared, no recurrence within six month; 6.8% of the abnormal sensation largely reduced within six month; 4.6% of the abnormal sensation reduced within six month. There was no significant postoperative pain. 3.6% (11/307) of patients experienced postoperative hemorrhage. The follow-up period ranged from 6 to 36 months, there was no recurrence. CONCLUSION Radiofrequency coblation is a useful surgical technique, as effective as,or even superior to,other surgical techniques when dealing with patients suffering from abnormal sensation of throat induced by the hypertrophy of lingual tonsil with potentially fewer adverse effects and subsequently improved quality of life for patients.
Adult ; Catheter Ablation ; methods ; Female ; Foreign-Body Reaction ; etiology ; surgery ; Humans ; Hypertrophy ; Male ; Middle Aged ; Palatine Tonsil ; pathology ; Tongue ; pathology ; Young Adult