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Inflammatory, Hypersensitivity and Immune Lung Diseases, including Parasitic Diseases.
Published in Fred W Wright, Radiology of the Chest and Related Conditions, 2022
The most common species is Actinomyces Israeli, but others including odontolyticus may give rise to clinical disease. The organisms are commonly found in tonsillar crypts and gingivo-dental tissues, and poor dental hygiene is usually present in those who develop chest infections. The organisms may cause infections in normal lungs, but tend to have a predilection for damaged or devitalised tissue, there being an increased incidence in patients with chest malignancy or in those who have had surgery. Infection may also occur in the abdomen, usually as chronic appendicitis and may present with a chronic fistula to the skin. In lung disease there is often a complicating infection with pyogenic aerobic and anaerobic bacteria. Clinical cases in the UK are rare, and the author has only seen a few, one complicating an old pneumonectomy cavity (similar to aspergillosis in Illus. MYCETOMA, Asperg Pt. 51). Further references are given below (two from the UK - Frank and Strickland, 1974 and Bellingham, 1990).
Oropharynx
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Tonsilloliths, or tonsil stones, are a soft collection of bacterial and cellular debris that form within the tonsillar crypts and are very common. They are most frequently associated with the palatine tonsils but can also be found within the lingual tonsils. Stoodley et al. demonstrated that tonsilloliths exhibit a biofilm structure and form chemical gradients through physiological activity [8]. There is oxygen respiration at the outer layer of the tonsillolith, denitrification toward the middle and acidification toward the bottom. The significance of this is not clearly understood yet.
Otorhinolaryngology
Published in Stephan Strobel, Lewis Spitz, Stephen D. Marks, Great Ormond Street Handbook of Paediatrics, 2019
Chris Jephson, C. Martin Bailey
Acute tonsillitis (Fig. 19.28) is usually bilateral and presents with a sore throat, fever, abdominal pain, dysphagia, otalgia and tender cervical lymphadenopathy. Chronic tonsillitis is defined as lasting 6 weeks or more. Features associated with chronic tonsillitis include dysphagia, halitosis, tonsillar hypertrophy or fibrosis, debris-filled tonsillar crypts, persistent cervical lymphadenopathy and poor general health.
Feasibility of p16 surrogate biomarker as adjunct diagnosis of oral and oropharyngeal malignancy in a resource-constrained country
Published in Acta Oto-Laryngologica, 2021
Marlinda Adham, Noval Aldino, Saffanah Zahra, Lisnawati Rachmadi, Saptawati Bardosono
In our study, tonsil is the most prevalent tumour site among HPV-positive patients. Tonsillar crypts cells, similar to cervical squamocolumnar junction cells, are more susceptible to a carcinogenic development compared to the cells in oral cavity. One of the reason may be that the highly invaginated crypts become natural hosts for infection, leading to an involvement of programmed cell death-1 ligand (PD-L1). Overexpression of PD-L1 supports persistent HPV infection which allows tumorigenesis [11]. Aside from tumour site, our histopathological examination showed that non-keratinizing SCCs tend to be HPV-positive, and vice versa. Our finding is consistent with a study that showed non-keratinizing SCC was significantly more likely to be HPV and p16 positive than keratinizing SCC (p < .001) [12]. HPV-positive HNSCCs mostly arise from tonsillar crypts, with a lack of significant keratinization [13].
Distinct microbial communities colonize tonsillar squamous cell carcinoma
Published in OncoImmunology, 2021
Angelina De Martin, Mechthild Lütge, Yves Stanossek, Céline Engetschwiler, Jovana Cupovic, Kirsty Brown, Izadora Demmer, Martina A. Broglie, Markus B. Geuking, Wolfram Jochum, Kathy D. McCoy, Sandro J. Stoeckli, Burkhard Ludewig
Patients suffering from obstructive sleep apnea (OSA) were prospectively enrolled in control cohort 1 with a total of 21 participants that underwent tonsillectomy between May 2017 and May 2020. Exclusion criteria were as follows: (a) acute or chronic tonsillitis, (b) any disease with immunosuppression, (c) immunosuppressive treatment, and (d) intake of antibiotics up to 4 weeks before surgery. After excision, tonsils were placed on a sterile surface and 4 mm punch biopsies (Stiefel® Biopsy punch) were taken using a sterile single-use stainless-steel instrument immediately in the operation theater using separate sterile pairs of scissors and forceps to avoid cross-contamination between samples. Two biopsies were punched out of the tonsil surface epithelium and two biopsies were taken from tonsillar crypts. Next, tonsils were cut in half with a sterile surgical blade and two lymphoid tissue samples were harvested by punch biopsy.