台耳醫誌

Lymphoid papillary hyperplasia (LPH) is an exceedingly rare disease of the palatine tonsils. Most cases have been reported to affect East Asian girls, mainly in Japan. A 12-year-old girl was referred to our outpatient clinic for bilateral tonsillar neoplasms. She felt a lumpy sensation in the throat, with loud snoring noticed by her family for about 6 weeks. Physical examination revealed irregular dome-shaped polypoid projections from her bilateral palatine tonsils. Bilateral tonsillectomy was performed, and the histopathologic study confirmed this rare diagnosis. LPH usually manifests as snoring, a lumpy throat, and even obstructive sleep apnea. Histopathologically, the disease has a distinctive form of lymphoid hyperplasia with considerable distinct dome-shaped projections composed of many phyllodes containing remarkable follicular lymphoid hyperplasia. The exact mechanism is unclear. One case report implicated family pedigree1, but most of the reported cases were sporadic. Some causal factors mentioned include repeated inflammatory stimulation, hormonal influence, Epstein-Barr virus infection, and T-lymphocyte-mediated immune response, which possibly play a critical role. The disease is easily cured without recurrence through tonsillectomy. Herein, we report the first case of LPH of the palatine tonsils in Taiwan.
(J Taiwan Otolaryngol Head Neck Surg 2021; 56:60-63)