Clinical significance and diagnostic approach for paediatric unilateral tonsillar enlargement: insights from a retrospective analysis.
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Authors
Nelson, A
Bujoreanu, I
Gaskin, J
Issue Date
2025-04-03
Type
Journal Article
Language
en
Keywords
Lymphoma , Paediatric , Tonsillar asymmetry , Unilateral tonsillar enlargement
Alternative Title
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.
Description
Open Access This is an open-access article distributed under the terms of the Creative mmons Attribution 4.0 International License, which permits unrestricted use, distribution, reproduction, and adaptation inany medium, provided the original work is properly attributed
Citation
Nelson, A.; Bujoreanu, I. and Gaskin, J. (2025) 'Clinical significance and diagnostic approach for paediatric unilateral tonsillar enlargement: insights from a retrospective analysis', Annals of the Royal College of Surgeons of England. Available at: https://doi.org/10.1308/rcsann.2024.0113
Publisher
Royal College of Surgeons of England
License
Journal
Annals of the Royal College of Surgeons of England
Volume
Issue
PubMed ID
ISSN
1478-7083