Tonsillar-glandular form of acquired acute toxoplasmosis

Kouba, K; Lasovská, J; Mirejovský, P; Stehlíková, J; Kramárová, K

doi:10.1017/s0022215100084103

Cited by 5 publications

(3 citation statements)

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“…Therefore, one might question our seven “idiopathic” cases: perhaps they represent serologically silent toxoplasmosis. Nevertheless, none of those patients exhibited concomitant adenopathy, a finding present in other reported cases of tonsillar toxoplasmosis, 19 and all of the patients had tonsillar symptoms for many years, a finding not likely to be found in toxoplasmosis.…”

Section: Discussionmentioning

confidence: 58%

“…Toxoplasma gondii typically affects the posterior cervical lymph nodes but has been described in the tonsils as well. 18,19 The characteristic histological pattern includes marked follicular hyperplasia and a granulomatous reaction within the germinal centers and at their immediate periphery. The granulomas are typically small and poorly delineated, but rarely may have areas of necrosis and giant cell formation.…”

Section: Discussionmentioning

confidence: 99%

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A Clinicopathologic Series of 22 Cases of Tonsillar Granulomas

Kardon

Thompson

2000

The Laryngoscope

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Objectives: Tonsils are uncommonly affected by granulomatous inflammation, often with an obscure cause. This study attempts to elucidate the nature of tonsillar granulomatous inflammation. Design: Retrospective clinicopathologic review. Methods: Twentytwo cases of tonsillar granulomas diagnosed between 1940 and 1999 were retrieved from the files of the Armed Forces Institute of Pathology. H&E slides and a series of histochemical stains were reviewed, and patient follow-up was obtained. Results: There were 11 males and 11 females, aged 7 to 64 years (mean, 29.9 y). Most of the cases presented bilaterally (n ‫؍‬ 19) with sore throat, dysphagia, and/or nasal obstruction. The clinical differential included chronic tonsillitis, tuberculosis, nonspecific infection, sarcoidosis, and a neoplasm. Histologically, the granulomas were focal and scattered, or diffuse, identified in the interfollicular zones (n ‫؍‬ 16) and/or the germinal centers (n ‫؍‬ 13), and occasionally associated with necrosis (n ‫؍‬ 6). Based on histochemical and clinical follow-up information, the etiology of the granulomas included sarcoidosis (n ‫؍‬ 8), tuberculosis (n ‫؍‬ 3), Hodgkin's lymphoma (n ‫؍‬ 2), toxoplasmosis (n ‫؍‬ 1), squamous cell carcinoma (n ‫؍‬ 1), and no specific known cause (n ‫؍‬ 7). Twelve patients were either alive at last follow-up or had died with no evidence of disease (mean, 12.4 y), and 9 were either alive at last follow-up or had died with disease (mean, 24.9 y). One patient was alive with unknown disease status (lost to follow-up after 13.3 y). Conclusions: Although a cause for tonsillar granulomas is frequently identified, a number may not develop an identifiable etiology, with the granulomas probably representing an exaggerated immune response to chronic tonsillitis. However, a careful work-up must be conducted to exclude specific causes and avoid clinical mismanagement.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

A Clinicopathologic Series of 22 Cases of Tonsillar Granulomas

Kardon

Thompson

2000

The Laryngoscope

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“…[6][7][8][9] The disease can also be extranodal, presenting as tonsillar enlargement with neck lymphadenopathy, pneumonitis, chorioretinitis, papulonodular dermatitis, myocarditis, or encephalitis, taking a grave form in immunocompromised hosts, especially those with acquired immunodeficiency syndrome (AIDS) and following organ transplants, in which pulmonary forms have been reported, with identification of the organisms in bronchoalveolar lavage specimens. 2,5,[10][11][12][13] The congenital form is transmitted from a mother having active infection via the placenta and has a devastating effect on the newborn, presenting with psychomotor and mental retardation, chorioretinitis, and encephalitis frequently accompanied by internal hydrocephalus. 1,4 The histologic picture of toxoplasma lymphadenitis is characterized by follicular hyperplasia with fair preservation of normal lymph node architecture, focal proliferation of transformed monocytoid B-lymphocytes, and small scattered clusters of large and epithelioid-like histiocytes, with larger aggregates of such cells, defined as granulomas, being rare.…”

Section: Discussionmentioning

confidence: 99%

Demonstration of parasites in toxoplasma lymphadenitis by fine‐needle aspiration cytology: Report of two cases

Zaharopoulos

2000

Diagn. Cytopathol.

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Demonstration of parasites in toxoplasma lymphadenitis by fine-needle aspiration cytology: Report of two cases

Zaharopoulos

2000

Diagn. Cytopathol.

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Two cases of toxoplasma lymphadenitis diagnosed by fine‐needle aspiration (FNA) cytology, in which the microorganisms were identified in the cytologic preparations, are presented. The first case was that of an 8‐yr‐old boy with bilateral cervical lymphadenopathy of 2‐mo duration, in which an FNA specimen of one of the lymph nodes in a Papanicolaou‐stained smear disclosed a toxoplasma cyst, and in Wright‐Giemsa preparation, dispersed tachyzoites and a pseudocyst. The second case was that of a 52‐yr‐old man with enlargement of a single lymph node in the neck, of 3‐mo duration, FNA of which in Wright‐Giemsa preparation disclosed numerous tachyzoites dispersed free in exudate, and also within cells, forming pseudocysts. In both cases, immunocytochemistry by the peroxidase method for Toxoplasma gondii antigen was positive. The tachyzoites seen in Wright‐Giemsa preparations, when subjected to fluorescence microscopy, emitted autofluorescence, facilitating their identification. While the presence of parasites in toxoplasma lymphadenitis is quite unusual, having been reported occasionally in histologic preparations and only rarely in cytologic FNA materials, our 2 cases suggest that in active disease, tachyzoites may not be so uncommon in FNA specimens. Besides the use of immunocytochemistry in the diagnosis of the disease, air‐dried preparations stained by the Wright‐Giemsa method are valuable for the demonstration of such parasites through careful search, along with the possible use of fluorescence microscopy. Diagn. Cytopathol. 2000;22:11–15. © 2000 Wiley‐Liss, Inc.

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Tonsillar-glandular form of acquired acute toxoplasmosis

Cited by 5 publications

References 1 publication

A Clinicopathologic Series of 22 Cases of Tonsillar Granulomas

A Clinicopathologic Series of 22 Cases of Tonsillar Granulomas

Demonstration of parasites in toxoplasma lymphadenitis by fine‐needle aspiration cytology: Report of two cases

Demonstration of parasites in toxoplasma lymphadenitis by fine-needle aspiration cytology: Report of two cases

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