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INTRODUCTION: In the evaluation of apparently negative tonsil biopsies, in particular lymphoid hyperplasia, the use of immunohistochemistry can help to exclude lymphoma and lyposys.
OBJECTIVE: To assess the usefulness of immunohistochemistry for the exclusion of lymphoid hyperplasia or lymphoma in tonsil biopsies.
DESIGN: Prospective study.
SETTING: A university otolaryngology outpatient department.
PATIENTS: Tonsil biopsies from consecutive patients referred because of negative results on histology for polyclonal lymphocytic infiltrates were assessed by the immunohistochemical profiles for leukocyte common antigen (CD45) and Epstein–Barr virus-encoded RNA.
RESULTS: A total of 238 diagnostic tonsil biopsies were assessed for leukocyte common antigen-positive lymphoid infiltrates. There were four negative cases (1.7%) that contained follicular lymphomas or diffuse large B-cell lymphomas, supporting the diagnosis of tonsillar lymphoid hyperplasia. One tonsil biopsy contained a marginal zone lymphoma.
CONCLUSIONS: Immunohistochemistry can be used to exclude lymphoid hyperplasia in a subgroup of cases. Only a limited number of cases of tonsillar lymphoma are missed in negative histology, but a systematic approach should always be taken when diagnosing lymphoid hyperplasia.
Footnotes
Contributors: This study
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