Association between unilateral tonsillar enlargement and lymphoma in children: A systematic review and meta-analysis

Guimarães, Alexandre Caixeta; Carvalho, Guilherme Machado de; Corrêa, Carlos Roberto Silveira; Gusmão, Reinaldo Jordão

doi:10.1016/j.critrevonc.2014.11.003

Cited by 13 publications

(22 citation statements)

References 36 publications

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“…In the same study, 25 patients with asymmetrical tonsils also presented with history of associated lymphadenopathy or mucosa ulceration; of this group, eight (25%) had evidence of malignancy . Oluwasanmi et al reported similar findings in 2008, showing two (2.3%) of 87 patients with asymptomatic UTE had lymphoma . In a systematic review by Randall et al in 2007, the results of 20 studies that reported on pathology in tonsillectomies were pooled, for a combined 54,901 patients.…”

Section: Literature Reviewmentioning

confidence: 91%

“…In three prospective case‐control studies, pathology of UTE and the accuracy of clinical assessment of asymmetry were studied. In two studies, matched groups of children with clinically symmetric and asymmetric tonsils underwent tonsillectomy with or without adenoidectomy . Removed tonsils were measured and examined grossly and microscopically.…”

Section: Literature Reviewmentioning

confidence: 99%

“…Furthermore, there was no evidence of lymphoma or other significant pathology in either group. The recommendation of these two articles, therefore, was for conservative management of children with asymptomatic asymmetry of the tonsils . However, in 2004, Cinar performed a study where 53 patients with asymmetric tonsils, ranging from 5 to 34 years old, were matched with 51 patients with symmetric tonsils .…”

Section: Literature Reviewmentioning

confidence: 99%

“…The recommendation of these two articles, therefore, was for conservative management of children with asymptomatic asymmetry of the tonsils . However, in 2004, Cinar performed a study where 53 patients with asymmetric tonsils, ranging from 5 to 34 years old, were matched with 51 patients with symmetric tonsils . The study showed a significant difference in the degree of asymmetry on measurement .…”

Section: Literature Reviewmentioning

confidence: 99%

“…Of the studies that reported retrospectively on UTE in adult populations, multiple studies suggested that UTE was most associated with malignancy in the setting of other suspicious symptoms, such as cervical lymphadenopathy, suspicious appearance of the tonsillar mucosa, and history of lymphoma . As such, these studies concluded that a “watch and wait” conservative approach was appropriate for adults without risk factors and low suspicion of malignancy.…”

Section: Literature Reviewmentioning

confidence: 99%

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What is the best management of asymptomatic unilateral tonsillar enlargement?

et al. 2015

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Section: Literature Reviewmentioning

confidence: 91%

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

Section: Literature Reviewmentioning

confidence: 99%

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What is the best management of asymptomatic unilateral tonsillar enlargement?

et al. 2015

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Assessment of Waldeyer's ring in pediatric and adolescent Hodgkin lymphoma patients—Importance of multimodality imaging: Results from the EuroNet‐PHL‐C1 trial

Kurch

Mauz‐Körholz

Fosså

et al. 2021

Pediatric Blood & Cancer

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Background In the EuroNet Pediatric Hodgkin Lymphoma (EuroNet‐PHL) trials, decision on Waldeyer's ring (WR) involvement is usually based on clinical assessment, that is, physical examination and/or nasopharyngoscopy. However, clinical assessment only evaluates mucosal surface and is prone to interobserver variability. Modern cross‐sectional imaging technology may provide valuable information beyond mucosal surface, which may lead to a more accurate WR staging. Patients, materials, and methods The EuroNet‐PHL‐C1 trial recruited 2102 patients, of which 1752 underwent central review including reference reading of their cross‐sectional imaging data. In 14 of 1752 patients, WR was considered involved according to clinical assessment. In these 14 patients, the WR was re‐assessed by applying an imaging‐based algorithm considering information from 18F‐fluorodeoxyglucose positron emission tomography, contrast‐enhanced computed tomography, and/or magnetic resonance imaging. For verification purposes, the imaging‐based algorithm was applied to 100 consecutive patients whose WR was inconspicuous on clinical assessment. Results The imaging‐based algorithm confirmed WR involvement only in four of the 14 patients. Of the remaining 10 patients, four had retropharyngeal lymph node involvement and six an inconspicuous WR. Applying the imaging‐based algorithm to 100 consecutive patients with physiological appearance of their WR on clinical assessment, absence of WR involvement could be confirmed in 99. However, suspicion of WR involvement was raised in one patient. Conclusions The imaging‐based algorithm was feasible and easily applicable at initial staging of young patients with Hodgkin lymphoma. It increased the accuracy of WR staging, which may contribute to a more individualized treatment in the future.

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