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Ectopic oral tonsillar tissue: a case series with bilateral and solitary presentations and a review of the literature.

Kimura M, Nagao T, Saito T, Warnakulasuriya S, Ohto H, Takahashi A, Komaki K, Naganawa Y - Case Rep Dent (2015)

Bottom Line: An ectopic tonsil is defined as tonsillar tissue that develops in areas outside of the four major tonsil groups: the palatine, lingual, pharyngeal, and tubal tonsils.In this report, we describe a rare case of bilateral symmetric ectopic oral tonsillar tissue located at the ventral surface of the tongue along with two solitary cases arising from the floor of the mouth.As an ectopic tonsil may simulate a benign soft tissue tumor, this case series highlights the importance of this entity in our clinical differential diagnosis of oral soft tissue masses.

View Article: PubMed Central - PubMed

Affiliation: Department of Dentistry Oral and Maxillofacial Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu 503-8502, Japan.

ABSTRACT
An ectopic tonsil is defined as tonsillar tissue that develops in areas outside of the four major tonsil groups: the palatine, lingual, pharyngeal, and tubal tonsils. The occurrence of tonsillar tissue in the oral cavity in ectopic locations, its prevalence, and its developmental mechanisms that belong to its formation remain unclear. In this report, we describe a rare case of bilateral symmetric ectopic oral tonsillar tissue located at the ventral surface of the tongue along with two solitary cases arising from the floor of the mouth. The role of immune system and its aberrant response leading to ectopic deposits desires further studies. As an ectopic tonsil may simulate a benign soft tissue tumor, this case series highlights the importance of this entity in our clinical differential diagnosis of oral soft tissue masses.

No MeSH data available.


Related in: MedlinePlus

(a) Histopathological findings of Case 1. Germinal center, lymphoid tissue, and a crypt (*) are seen (Hematoxylin-Eosin (HE), scale bar = 250 μm). (b) Lymphoepithelial symbiosis in the crypt is seen (arrows) (HE, scale bar = 250 μm).
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fig2: (a) Histopathological findings of Case 1. Germinal center, lymphoid tissue, and a crypt (*) are seen (Hematoxylin-Eosin (HE), scale bar = 250 μm). (b) Lymphoepithelial symbiosis in the crypt is seen (arrows) (HE, scale bar = 250 μm).

Mentions: A 53-year-old Japanese male, referred by his general dental practitioner, presented with small, bilaterally symmetric masses on the ventral surface of the tongue, noticed during a routine dental examination 2 months ago. The areas affected were painless and remained unchanged in size over the previous 2 months. Intraoral examination revealed hard masses of 8 mm diameter (right) and 6 mm diameter (left) on the ventral surface of the tongue (Figure 1). The surface covering of these masses was slightly red and was hard on palpation. Clinically, a small pit was evident at the tip of both masses; a provisional diagnosis of bilateral benign tumors of salivary origin was made. An excision biopsy of the mass on the right side was subsequently performed under local anesthesia. The mass was easily resected and the postoperative course was uneventful. Histopathological findings showed a germinal center, lymphoid tissue, and lymphoepithelial symbiosis in the crypt (Figure 2). Although the bilateral symmetric ectopic oral tonsillar tissue arising from this region has not been reported elsewhere to our knowledge, clinicopathological characteristics were similar to two other cases (Cases 2 and 3) of solitary origin presented later in our clinic (Table 2).


Ectopic oral tonsillar tissue: a case series with bilateral and solitary presentations and a review of the literature.

Kimura M, Nagao T, Saito T, Warnakulasuriya S, Ohto H, Takahashi A, Komaki K, Naganawa Y - Case Rep Dent (2015)

(a) Histopathological findings of Case 1. Germinal center, lymphoid tissue, and a crypt (*) are seen (Hematoxylin-Eosin (HE), scale bar = 250 μm). (b) Lymphoepithelial symbiosis in the crypt is seen (arrows) (HE, scale bar = 250 μm).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4309306&req=5

fig2: (a) Histopathological findings of Case 1. Germinal center, lymphoid tissue, and a crypt (*) are seen (Hematoxylin-Eosin (HE), scale bar = 250 μm). (b) Lymphoepithelial symbiosis in the crypt is seen (arrows) (HE, scale bar = 250 μm).
Mentions: A 53-year-old Japanese male, referred by his general dental practitioner, presented with small, bilaterally symmetric masses on the ventral surface of the tongue, noticed during a routine dental examination 2 months ago. The areas affected were painless and remained unchanged in size over the previous 2 months. Intraoral examination revealed hard masses of 8 mm diameter (right) and 6 mm diameter (left) on the ventral surface of the tongue (Figure 1). The surface covering of these masses was slightly red and was hard on palpation. Clinically, a small pit was evident at the tip of both masses; a provisional diagnosis of bilateral benign tumors of salivary origin was made. An excision biopsy of the mass on the right side was subsequently performed under local anesthesia. The mass was easily resected and the postoperative course was uneventful. Histopathological findings showed a germinal center, lymphoid tissue, and lymphoepithelial symbiosis in the crypt (Figure 2). Although the bilateral symmetric ectopic oral tonsillar tissue arising from this region has not been reported elsewhere to our knowledge, clinicopathological characteristics were similar to two other cases (Cases 2 and 3) of solitary origin presented later in our clinic (Table 2).

Bottom Line: An ectopic tonsil is defined as tonsillar tissue that develops in areas outside of the four major tonsil groups: the palatine, lingual, pharyngeal, and tubal tonsils.In this report, we describe a rare case of bilateral symmetric ectopic oral tonsillar tissue located at the ventral surface of the tongue along with two solitary cases arising from the floor of the mouth.As an ectopic tonsil may simulate a benign soft tissue tumor, this case series highlights the importance of this entity in our clinical differential diagnosis of oral soft tissue masses.

View Article: PubMed Central - PubMed

Affiliation: Department of Dentistry Oral and Maxillofacial Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu 503-8502, Japan.

ABSTRACT
An ectopic tonsil is defined as tonsillar tissue that develops in areas outside of the four major tonsil groups: the palatine, lingual, pharyngeal, and tubal tonsils. The occurrence of tonsillar tissue in the oral cavity in ectopic locations, its prevalence, and its developmental mechanisms that belong to its formation remain unclear. In this report, we describe a rare case of bilateral symmetric ectopic oral tonsillar tissue located at the ventral surface of the tongue along with two solitary cases arising from the floor of the mouth. The role of immune system and its aberrant response leading to ectopic deposits desires further studies. As an ectopic tonsil may simulate a benign soft tissue tumor, this case series highlights the importance of this entity in our clinical differential diagnosis of oral soft tissue masses.

No MeSH data available.


Related in: MedlinePlus