Relation between actinomycosis and histopathological and clinical features of the palatine tonsils: a comparative study between adult and pediatric patients.

ABSTRACT

OBJECTIVE: To find out the incidence of actinomyces in the palatine tonsil of the adult and pediatric patients, and evaluate our results relevant to the clinical diagnoses and histopathological features of tonsillectomy specimens. METHODS: The medical records of 1820 tonsillectomies, which were performed in the Department of Otolaryngology between 1987 and 2002 were retrospectively reviewed. The paraffin embedded specimens of the patients were also obtained for histopathologic assessment, and Hematoxylin-Eosin stained sections re-evaluated mainly for cryptitis and actinomycosis. RESULTS: There was actinomyces in 122 (6.7%) of 1820 patients, of whom 62 were adult and 60 were pediatric patients. That is, actinomyces was present in 62 (10.9%) of 568 adult patients, and 60 (4.8%) of 1252 pediatric patients. The rate of actinomyces was significantly higher in adults than children (p < 0.01). There was no correlation between the clinical diagnoses and the histopathologic parameters assessed (p > 0.05). On histopathology, the cryptitis was encountered in 53 (85%) of 62 adult patients and 47 (78%) of 60 pediatric patients with actinomyces (p > 0.05). The rate of cryptitis was significantly higher in the presence of actinomyces both in adult and pediatric patients (p < 0.05). CONCLUSION: There was no correlation between the clinical diagnosis of tonsillar disease and the presence of actinomycosis both in adult and pediatric patients. Histopathologic findings of adult and pediatric tonsillectomy material was similar except for the higher rate of actinomycosis in the adults than in children. However, cryptitis was a substantial finding in the presence of actinomycosis. Based on the significant association of cryptitis with actinomycosis, cyptitis can be considered a histopathologic indicator for tonsillar actinomycosis.