Clinical significance and diagnostic approach for paediatric unilateral tonsillar enlargement: insights from a retrospective analysis
Year: 2025
Type: article
Study design: Observational Study
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.
Authors: A Nelson, I Bujoreanu, J Gaskin
Institutions: Bristol Royal Hospital for Children, Musgrove Park Hospital
Language: English
Subfield: Rheumatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4409120673