Tonsils & Adenoids

Auto text: “Insert Tonsil Benign” or “Insert Tonsil Tumor”


  1. Weigh each tonsil and adenoid.
  2. Measure each tonsil and adenoid in three dimensions.
  3. Benign: Obstructive sleep apnea (OSA) or tonsillitis can be grossed fresh. Serially section, examine, and submit sections (at least one representative section of each tonsil and adenoid) in ONE cassette, regardless of age. ** 3 cassettes no longer needed as of 7-13-16
  4. Possible Tumor: For clinically suspicious lesions, tonsillar asymmetry, neck mass with unknown primary, or known cancers:
    • If oriented: treat as an oriented mucosal excision.
    • If unoriented: ink the deep margin and measure any grossly apparent surface lesion. If you can cut thin slices, you can gross these fresh. If not, fix in formalin overnight. To gross: serially section, measure any mass lesion in 3D, and submit the entire tonsil. If you can submit perpendicular sections of the tips, please do so.
  5. Lymphoma: Please see Lymphoma Work-Up in the Heme section for proper triage.

This tonsil is not normal: it contains a fleshy mass that effaces the normal crypt architecture.

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