A STUDY OF INCIDENCE OF ACTINOMYCOSIS IN TONSILLECTOMY SPECIMENS, ETIOLOGICAL SIGNIFICANCE AND HISTOPATHOLOGY FEATURES IN A REGION OF RURAL TELANGANA
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 33
Abstract
BACKGROUND Actinomycosis of the tonsillar tissue is a rare pathological condition whose clinical significance has been disputed by authors worldwide. This is a retrospective study of tonsillectomy specimens resected for chronic tonsillitis which showed actinomyces on microscopic examination. The histopathology of the tonsillectomy specimens revealed colonies of actinomyces in tonsillar crypts, along with cryptitis and reactive lymphoid hyperplasia. The question as to whether the presence of colonies in tonsils is incidental or causative for tonsillar lesions is still not definitely solved. The present study was conducted to determine the histopathological features of tonsils and significance of actinomycosis in chronic tonsillitis. The aim of our study is to evaluate the histopathological features of tonsillectomy specimens with actinomyces and to determine the etiological significance of actinomyces in chronic tonsillitis. METHODS 30 chronic/recurrent tonsillitis patients who underwent bilateral tonsillectomy were subjected to histopathological study and 10 were found to have actinomycotic granules. The age group of the tonsillectomy patients in our study ranged from 7 to 32 years. Tonsillectomy biopsy specimens were stained with Haematoxylin-Eosin, Gram stain, PAS and GMS and were evaluated with light microscopy for the presence of actinomyces, signs of significant cryptitis or active tonsillitis and reactive lymphoid hyperplasia. The data was further analysed to determine the statistical significance. RESULTS 10 cases (20 tonsillectomy biopsy specimens) with a mean age of 21.4 years (ranging from 13 to 32 years) were considered in this study. Actinomyces were seen in 12 tonsillar specimens only. Histopathological study of tonsillectomy biopsy specimens showed chronic tissue infection. We found a significant statistical relationship between the age and the presence of actinomycosis as actinomyces colonies were found more frequently in adult patients with female preponderance. There was no causative correlation between actinomyces colonies and chronic tonsillitis in our study. CONCLUSIONS The histopathological examination of tonsils in the present study documents tissue reaction to the actinomyces colonies in 10% of the cases. The age of the patient and female preponderance of tonsillar actinomycosis in adults correlate with the findings of other authors in previous studies. The high incidence of actinomyces colonisation in the resected tonsillar specimens in this region advocates the need for further research for the immunological role of the organism in the tonsillar disease.
Authors and Affiliations
Vijaya Lakshmi Koduri, Santhoshi G, Bheeshma Bheeshma
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