Tonsil pathology

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Congenital abnormalities

Choristoma:

" hairy polyp" arising from the remnants of the ectodermal and mesodermal layers in the palatine tonsil and nasopharynx.

Viral tonsilitis

1. EBV

Infects epithelial cells and B cells in Waldeyer ring

Primary infections in infancy (developing countries) and adolescents/young adults (developed countries) infectious mononucleosis.

Surface epithelium necrotic

Follicular hyperplasia with fused, bizarre shaped follicles

Numerous tangible body macrophages.

Distended interfollicular areas with atypical immunoblasts (B/T; CD30+), plasma cells, plasmatoid lymphocytes and histiocytes.

Numerous mitosis

Rare Reed-Sternberg cells (single/multiple nuclei without nucleoli beneath crypt epithelium).

Infected cells are EBV positive.-> EBV nuclear antigen postitive and latent membrane protein (LMP).

Ddx (esp older patients): Extranodal manifestation of HL and NHL (large cell and immunoblast type.