The emigration of lymphocytes from palatine tonsils after local labelling

Summary Lymphocytes in the palatine tonsils of normal young pigs were selectively labelled by minute multiple injections of fluorescein isothiocyanate into the tonsils. One day later the numbers of tonsil-derived lymphocytes were determined in cervical, bronchial and mesenteric lymph nodes, spleen, Peyer's patches, thymus, bone marrow and blood. Although not all tonsillar lymphocytes could be labelled by this technique, a total of 0.6×10⁹ lymphocytes emigrated from the tonsils. Relatively more lymphocytes were found in lymph nodes than in the spleen and very few in the thymus, Peyer's patches and bone marrow. This organ distribution was different from the results from selectively labelling lymphocytes in lymph nodes, spleen and bone marrow.     

Proliferation of cells and intracellular c-AMP content: Comparative investigations of autologous lymphatic cells from palatine tonsils,nasopharyngeal tonsils,and blood

Summary The c-AMP content and thymidine incorporation were determined in tonsillogenic, adenoid, and peripheral lymphatic cells. A significant c-AMP decrease with simultaneous increase of the thymidine incorporation compared to the blood lymphocytes was noted in the tonsillogenic and adenoid cells. The negative regulative effect of c-AMP on cell proliferation and the function of tonsils at this processes are discussed.     

Multifocal human papillomavirus detection in palatine and pharyngeal tonsils

Background: Multifocal human papillomavirus (HPV) infection into the palatine and pharyngeal tonsils, which might be linked to a second primary tumor of HPV-positive oropharyngeal cancer (OPC), was investigated.

Patients and methods: One hundred and five patients with various head and neck diseases including 14 patients with OPC were enrolled in this study. Swabs from the palatine and pharyngeal tonsils were collected in each individual, and auto-nested GP5+/GP6+ PCR for HPV DNA was performed.

Results: HPV DNA was detected in the palatine tonsil or the pharyngeal tonsil in a small subset of upper respiratory tract cancer other than OPC (URTC) and non-cancer diseases. Furthermore, HPV DNA was detected in both the palatine and pharyngeal tonsils in the same individual in 2 of 48 (4%) URTC cases, and 1 of 43 (2%) non-cancer cases. On the other hand, p16-positive OPC cases demonstrated a higher HPV DNA detection rate (4 of 9, 44.4%) compared with other disease groups.

Conclusion: HPV DNA detection in both the palatine and pharyngeal tonsils in the same individual, especially in HPV-OPC, suggested the ability of HPV to infect tonsillar tissues of Waldeyer’s ring multifocally.     

Defensin and chemokine expression patterns in the palatine tonsil: a model of their local interaction

Defensins and chemokines are an essential part of the immune response mechanisms in the head and neck mucosa. This work investigates their correlation and their expression pattern in tonsillar disease. Forty-four tonsil tissue samples were obtained from patients who underwent tonsillectomy between 1998 and 1999 for chronic tonsillitis with ( n =9) and without ( n =25) inflammatory infiltrates and hyperplasia of the tonsil ( n =10). Defensin (hBD-1, hBD-2, HNP-1 and HNP-4) and chemokine (RANTES, eotaxin, eotaxin-2, MCP-3, MCP-4 and IL-8) mRNA expressions were analyzed by SQRT-PCR. HNP-4 and eotaxin-2 expressions were positively correlated ( P <0.05) in the acute tonsillitis group. HBD-2 and MCP-3 expressions were positively correlated in the hyperplastic tonsils group. Within all groups together, HNP-4 and RANTES expressions were highly positively correlated ( P <0.01), and HNP-1 and hBD-2 were positively correlated with IL-8 expressions. Immunohistochemistry demonstrated eotaxin-1 as well as IL-8 production to be predominantly located within the lymphoid follicles and submucosa. RANTES production was shown in the epithelial lining and perivascular tissue. The expression of hBD-1 and hBD-2 was limited to the epithelial lining. Our data support an association between the innate and acquired immune systems on the defensin-chemokine level. The finding of positively correlated hBD-2 and IL-8 expression is biologically relevant because of the proximity of hBD-2 (epithelium) and IL-8 (submucosa) release, as well as the synergistic support of the Th1 system. In addition, our data suggest RANTES as a first-line mediator of perivascular leukocyte recruitment.     

Inflammatory markers in palatine tonsils of children with obstructive sleep apnea syndrome

IntroductionObstrutive sleep apnea syndrome is characterized by repeated episodes of upper airway obstruction, associated with intermittent hypoxia and hypercapnia, and the main risk factor in childhood is adenotonsillar hypertrophy. The lymphocytes in these structures are responsible for local and systemic immune responses.ObjectiveVerify the levels of the inflammatory markers, IL-1β, IL-4, IL-6, IL-8, IL-10, IL-15, TNF-α, CRP and α1-GP, in the tonsils of children with and without obstructive sleep apnea syndrome.MethodsThis cross-sectional prospective study included 34 children with complains of snoring, difficulty breathing during sleep or recurrent tonsillitis. Patients underwent to a complete otorhinolaryngological examination, nasal endoscopy and polysomnography and were divided into two groups with 17 children each: obstructive sleep apnea syndrome group and control group. All underwent an adenotonsillectomy. Cytokines were measured in the collected tonsils (ELISA and Multiplex methods).ResultsStatistically significant increasing were observed between IL-8 and IL-10 cytokines of patients with obstructive sleep apnea when compared to the control group; also between c-reactive protein and α1-GP of the tonsils cortical region in children with obstructive sleep apnea syndrome when compared with the medullary region. There were no statistically significant differences for the remaining inflammatory mediators.ConclusionAfter the analysis of the levels of pro and anti-inflammatory markers (IL-1β, IL-4, IL-6, IL-8, IL-10, Il-15, TNF-α, CRP, α1-GP) in the tonsils, we observed higher levels of markers IL-8 and IL-10 in pediatric patients with obstructive sleep apnea syndrome.     

TLR-4、TLR-9 mRNA在变应性鼻炎儿童扁桃体组织中的表达

目的分析Toll样受体-4(TLR-4)和Toll样受体-9(TLR-9)mRNA在变应性鼻炎(allergic rhinitis,AR)儿童扁桃体组织中的表达及意义。方法应用RT-PCR检测20例变应性鼻炎(第1组)、20例慢性鼻窦炎(第2组)和20例无鼻部疾病正常儿童(第3组)的扁桃体组织中TLR-4、TLR-9 mRNA的表达情况。结果 TLR-4、TLR-9 mRNA在第1组儿童扁桃体组织中均有表达,其中TLR-4 mRNA在第1组、第2组儿童组织中的相对含量较第3组表达增强,差异有统计学意义(P<0.01);第1组较第2组增高,差异有统计学意义(P<0.01)。TLR-9 mRNA在第1组的相对含量与第2组及第3组间相比,第1组表达明显增高,差异有统计学意义(P<0.0 1);其中第2组与第3组中的TLR-9 mRNA含量比较差异无统计学意义(P>0.0 5)。结论 TLR-4、TLR-9可能在变应性鼻炎儿童扁桃体增殖过程中起重要作用。     

Prevalence of the Helicobacter pylori in the tonsils and adenoids

IntroductionThere is an ongoing debate about the existence and effects of Helicobacter pylori (Hp) in adenotonsillar tissue.ObjectiveA clinical study was conducted to assess the existence of Hp in the adenoid and/or adenotonsillar tissues, which were surgically excised due to chronic adenotonsillitis.MethodsPhosphoglucosamine mutase gene for the detection of Hp and cytotoxin-associated gene as virulence gene were examined in 84 adenotonsillar tissues obtained from 64 patients and patients’ serum by using polymerase chain reaction.ResultsHp IgG was detected in 57 (89%) patients’ serum. A total of seven tissue samples from 64 patients (10.9%) were found positive for Hp DNA, of which five were adenoids and two were tonsil tissues. All polymerase chain reaction positive samples were also positive for the cytotoxin-associated gene, which is a virulence determinant for the organism.ConclusionThis study suggests that children are exposed to Hp at an early age of their life in this province. Hp may have a role in the pathogenesis of chronic adenotonsillitis, especially in endemic areas.     

Primary mucosal melanoma of the palatine tonsil: Report of a case and review of the literature

Background

Mucosal melanoma of the palatine tonsil is extremely rare. Due to its poor prognosis, primary tonsillar melanoma requires prompt recognition and treatment.

睡眠呼吸障碍儿童扁桃体及腺样体组织细菌学分析

目的　探讨睡眠呼吸障碍（sleep disordered breathing,SDB）儿童扁桃体及腺样体组织的细菌学特点。方法　经多导睡眠图监测确诊的163例SDB患儿纳入研究,其中120例同时接受扁桃体及腺样体切除术,4例接受单纯扁桃体切除术,39例接受单纯腺样体切除术,124例接受扁桃体切除术的患儿按照有无扁桃体炎反复发作的病史分为两组,扁桃体炎组71例和无扁桃体炎组53例。术中取部分扁桃体和（或）腺样体组织进行细菌学检查。结果　120例患儿中的114例（95.00%）两个部位分离出的细菌种类相同,120例中有17例（14.17%）两个部位均感染了两种细菌,混合感染的细菌种类均相同。在各个季节两个部位中金黄色葡萄球菌和流感嗜血杆菌的检出率无显著性差异（扁桃体：χ2=8.538,P =0.201;腺样体：χ2=5.427,P =0.490）。有无慢性扁桃体炎病史的扁桃体组织内的各种细菌检出率无显著性差异（χ2=3.028,P =0.387）。结论　同一个SDB患儿的扁桃体和腺样体组织检出的细菌种类几乎相同,有无慢性扁桃体炎病史的扁桃体组织内的不同细菌检出率无显著性差异。     

S-100 protein-positive dendritic cells and CD34-positive dendritic interstitial cells in palatine tonsils

Dendritic cells (DCs) are effective antigen-presenting cells and have been shown to mature from precursor CD34-positive stromal cells (dendritic interstitial cells, DICs) or monocytes. To gain insight into the local immune response in human tonsils, we investigated immunohistochemically the presence of DCs and DICs in 17 non-hyperplastic and 13 hyperplastic tonsils. Dense infiltrates of S-100-positive DCs were noted in the majority of hyperplastic tonsils, while there were fewer in non-hyperplastic tonsils. DICs were noted specifically at the periphery in the dense hemi-capsule cap that separates the tonsil from the underlying muscle. In addition, their small number suggests that the accumulation of S-100 dendritic cells in hyperplastic palatine tonsils is achieved through migration from other sites rather than through maturation from precursors locally. Received: 19 December 2000 / Accepted: 10 April 2001     

Spontaneous Tonsillar Hemorrhage and Post-Tonsillectomy Hemorrhage

Spontaneous tonsillar hemorrhage from infectious causes is extremely rare and post-tonsillectomy hemorrhage, although also relatively rare, is an unavoidable complication of the procedure. Hemorrhage in association with tonsillitis or tonsillectomy is potentially dangerous and can be life threatening. We report here the presentation and management of a 42-yr-old man with severe spontaneous hemorrhage from infected tonsils and post-tonsillectomy hemorrhage. We suggest that if attempts to control the bleeding are not successful or if severe spontaneous tonsillar hemorrhage occurs repeatedly or a malignancy is suspected, tonsillectomy and close postoperative follow up is recommended.     

从吞噬作用探讨腭扁桃体的功能

为观察成年动物腭扁桃体功能，以家兔为实验动物，用台盼蓝和炭素墨水腹腔内注射作活体染色，９天后采标本研究观察腭扁桃体的吞噬功能。同时取脾脏、胸腺及淋巴结等进行检查。结果提示：四种淋巴器官中只见脾脏和淋巴结的吞噬细胞吞噬大量色素颗粒，而腭扁桃体则和胸腺一样，未见有吞噬血流和淋巴液中的异物的现象。因此推断，腭扁桃体作为淋巴器官，其主要功能是在儿童期，特别是婴儿期，接触体表外来抗原，参与免疫应答，建立完备的免疫机制。童年以后腭扁桃体即渐萎缩，功能渐退化，一旦腭扁桃体成为慢性病灶，则在正确掌握适应证的基础上进行手术切除是必要的     

腭部肿瘤61例临床分析

目的 探讨腭部肿瘤的临床特征和治疗原则。方法 腭部肿瘤患者61 例行手术治疗,良性肿瘤44 例,其中腺源性良性肿瘤28例;恶性肿瘤17例, 腺源性恶性肿瘤11 例。良性肿瘤进行了局部切除,恶性肿瘤进行了局部扩大切除,部分使用局部或者颈部的组织瓣和脱细胞真皮基质进行修复,术后2例鳞状细胞癌患者进行放疗。结果 良性肿瘤44例未见复发;恶性肿瘤11例中1例混合瘤恶变,术后2年局部复发;1例鳞状细胞癌术后1年出现肺部转移。结论 腭部肿瘤以良性肿瘤为主,恶性肿瘤应根据情况进行放射治疗,并修复软腭的功能。     

Anatomy and physiology of the palatine tonsils,adenoids, and lingual tonsils

ObjectiveThis review aims to discuss the basic anatomy and physiology of the palatine and pharyngeal tonsils, with reference to how this foundational understanding may affect patient management and surgical procedures in these regions of the upper airway.MethodsA literature search was performed using PubMed and Google Scholar using the MeSH terms tonsils, adenoids, anatomy, physiology, and adenotonsillectomy. Primary sources were excluded if they were abstracts only, non-English language, or non-human studies. Thirty-five sources were included in this review.Results and conclusionsThe pharyngeal and palatine tonsils are compact yet physiologically complex mucosa-associated lymphoid tissues that make up a portion of Waldeyer's ring. As part of the mucosal immune system, these structures function in exogenous antigen sampling and stimulation of immune responses. Aberrant immune activation and/or regulation can lead to a myriad of pathologies, with adenotonsillar hypertrophy, chronic tonsillitis/adenoiditis, and recurrent otitis media among the most commonly encountered conditions by otolaryngologists. While the pathophysiology of these conditions is still incompletely understood, current evidence and future investigations may reveal patterns amenable to targeted medical management. When medical management fails, tonsillectomy and/or adenoidectomy may be indicated for patient care. Though routine procedures, the execution of tonsil and/or adenoid removal requires a thorough understanding of the anatomy of these lymphoepithelial organs so as to minimize the risk for rare serious complications that can occur.