Lingual (Not Palatine) Tonsillolith: Case Report

Subgemmal neurogenous plaque: a series of six cases and a literature overview

The study aims to describe six subgemmal neurogenous plaque (SNP) cases and compile the previously available data on SNP. Searches on PubMed, Web of Science, Embase, Scopus, and a two-step study selection were performed to compile data from case reports/series of SNP published in English literature. Our six patients (range 29-63 years) had SNP in the posterior lateral border of the tongue. Four of them were associated with lymphoepithelial cysts. A total of 15 studies, comprising 116 patients, were included in this overview. There was a slight predilection for female patients (56.0%) in the 5th (22.4%) and the 7th (23.9%) decades. The lateral border of the tongue (66.4%) was the most common anatomical location. The major manifestation was nodule/papule. Histologically, the presence of taste buds (n = 40/ 34.5%), superficial neural plexus (n = 32/ 27.6%), deep nerve fascicles (n = 32/ 27.6%), ganglion cells (n = 41/ 35.3%), and lymphoid tissue (n = 22/ 19.0%) was mainly reported. Surgical removal was the primary approach, with a low recurrence rate. Although largely unknown, SNP is a regular and likely frequent structure located in the tongue. The findings emphasize the importance of describing clinicopathological patterns of SNP as a differential diagnosis of neural lesions that affect the tongue.

Adenoid stones, an unknown culprit in pediatric throat pain

We present a case of a 12-year-old male who presented with complaints of nasal congestion, intermittent throat pain, and odynophagia. He was taken to the operating room for inferior turbinate reduction and adenoidectomy and found to have stones within adenoid crypts. Adenoidectomy resulted in resolution of the patient's throat pain and pain with swallowing. Not previously described in the literature, adenoid stones may represent an unrecognized etiology of odynophagia and throat pain in the pediatric population. Adenoidectomy should be considered for patients symptomatic from adenoid stones.

Tonsillolith

Small tonsilloliths are usually asymptomatic, whereas large tonsilloliths are sometimes associated with recurrent sore throat and odynophagia.

Unilateral enlargement of the lateral lingual tonsil: An immunohistochemical study and literature review

Besides the Waldeyer's ring, other lymphoid aggregates can also be detected in the soft palate, floor of the mouth and ventral tongue. The lingual tonsil is located at the base of the tongue and related to circumvallate papillae, whereas subepithelial lymphoid tissue at the posterior lateral portion of the tongue and related to foliate papillae constitutes the lateral lingual tonsil. Unilateral tonsillar enlargement is critical, because it can suggest malignancy, notably non-Hodgkin lymphoma or squamous cell carcinoma. Herein, we report an unusual presentation of unilateral enlargement of the lateral lingual tonsil, diagnosed as follicular lymphoid hyperplasia.

An Uncommon Case of Partial Airway Obstruction due to Lingual Tonsillar Hypertrophy

Obstruction of the airway is a medical emergency. If it is not treated immediately, rapid and potentially life-threatening hypoxia develops. A 70-year-old woman with a history of hypertension and palatine tonsillectomy presented to our tertiary care hospital with dysphagia, odynophagia, muffled voice, and neck swelling of a one-week duration. She also complained of associated shortness of breath that began two days prior to hospital admittance. Bedside laryngoscopy revealed an enlarged base of the tongue and laryngeal edema, resulting in partial airway obstruction. A CT scan of the soft tissue of the neck revealed that lingual tonsillar hypertrophy (LTH) was the cause of the partial airway obstruction. While being closely monitored, the patient was treated with intravenous corticosteroids and antibiotics. Serial laryngoscopies were performed to track the resolution of the airway obstruction. Her hospital course remained uneventful, and the patient was discharged after four days. Though rare, LTH has a strong propensity to cause airway compromise, and it must be treated at once.