CC BY
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© КОЛЛЕКТИВ АВТОРОВ, 2017 UDC 616.322-002-07
A. Cheçcâ1, T. Sandle2
STRUCTURAL ASPECTS ON TONSILLITIS
1Faculty of Medicine, Transilvania University of Bra§ov (Bra§ov, Romania), 2University of Manchester (United Kingdom)
The present study shows structural issues relating to various forms of tonsillitis, frequently encountered in clinical practice. For the study, it was observed and analyzed with light microscopy, permanent preparations made by processing samples taken from intraoperative fragments. It is useful to undertake microscopic examination of samples in order to help establish accurate pathologic diagnosis.
Keywords: tonsillitis, pathology, microscopy, analysis, diagnosis
Tonsillitis is one of the most frequent pathologies, especially with young children [2]. Tonsillitis occurs due to various factors, including being the result of bacterial, viral or fungal pathogens [1, 6]. Symptoms may include sore throat and fever. These microorganisms can activate an immune deficiency leading to the disease onset [3, 4, 5]. Once diagnosed, acute tonsillitis measures need to be taken to prevent the reactivation of the disease and to contain exacerbation [7, 8, 9]. Reactivation flares of tonsillitis - chronic tonsillitis - leads to adverse repercussions on individual health. This is by affecting organs (heart or kidney) and potentially the osteoarticular system [2, 11]. The seriousness of the condition and its negative impact on individual health requires tonsillectomy as a curative measure [10]. Most tonsillectomies involve using a conventional scalpel to remove the tonsils; alternatives to this traditional method include the use of lasers, radio waves, ultrasonic energy, or electrocautery to cut, burn, or evaporate away enlarged tonsils.
MATERIAL AND METHODS
For this structural study, fragments taken intraoperatively, excised by practicing tonsillecto-my, were analyzed. The pieces were processed by classical histological technique and scrubbed, using Hematoxylin- Eosin staining (the application of hemalum, and hematein). Observations of the microscopic preparations for diagnosis were made using Nikon microscopes and magnifying lenses with different powers, respectively x10 and x40, for the overall observation of structural details.
The following forms of tonsillitis were examined using this procedure:
• reactive chronic tonsillitis
• chronic tonsillitis reactive with inflammatory foci
• chronic cryptic tonsillitis with reactive deposits
• chronic reactive tonsillitis with reactive scar postinflammatory scar changes
• chronic reactive tonsillitis with sclerocica-triciale changes
• chronic reactive tonsillitis with scleroreac-tive scars
RESULTS AND DISCUSSION
The microscopic analysis of operative fragments, excised from patients operated on for various forms of tonsillitis, allowed the diagnosis of various forms of tonsillitis to be conducted. Undertaking these reviews provides the basis for others to benchmark for accuracy. These are presented below.
The first figure represents the follicle appearance in chronic tonsillitis tonsil with reactive inflammatory foci. Net delimitation stands pretty limits tonsillar follicle (fig. 1). In Figure 2, it can be seen the appearance of follicle amygdala and its adjacent areas. This image follows the previous one, being subjected to microscopic observation same form of tonsillitis respectively chronic tonsillitis reactive with inflammatory foci (fig. 2). The following image shows the specific morphological appearance reactive chronic tonsillitis. (fig. 3). With the study were included various forms of tonsillitis. The image below shows the microscopic appearance of specific chronic tonsillitis if sclerocicatriciale
Figure 1 - Pathologic tonsillitis image H&Ex10
Figure 2 - Pathologic tonsillitis H&Ex10 Figure 3 - Pathologic tonsillitis H&Ex10
^mmsm wmmm
Figure 4 - Pathologic tonsillitis H&E x 10
changes. Surprise in the image are areas that characterize this form of tonsillitis (fig. 4).
The following picture shows the same form of tonsillitis as in the picture above. However, with this picture it can be observed the stratified squamous epithelium without keratinization on the left side; and on the right side of the image features form of chronic tonsillitis areas with sclerocicatriciale changes can be seen. The two areas mentioned are separated by amigdalian sept; this appears on the image in a weaker color compared with the other two areas together with the mentioned morphological features described above (fig. 5).
CONCLUSION
Morphological analysis of various forms of tonsillitis is useful in order to establish a greater certainty of pathologic diagnosis. Completing an analysis is useful for the study of microscopic preparations using classical histological technique together with new investigative techniques such as immunohistochemistry (the detection of antigens in cells of a tissue section, based on the properties of antibodies to bind specifically to
Figure 5 - Pathologic tonsillitis H&Ex10
antigens in biological tissue). This approach allows for material objects to be presented for scientific aspects pathologic diagnosis, as determined by structural observations. The images and descriptions presented here provide structural benchmarks for medical practitioners to compare.
REFERENCES
1 Baglam T. Predictive value of the neutrophil-to-lymphocyte ratio in patients with deep neck space infection secondary to acute bacterial tonsillitis /T. Baglam, A. Binnetoglu, A. C. Yumusakhuylu //Journal of pediatric otorhino-laryngology. - 2015. - №79 (9). - P. 1421-1424.
2 Bartlett A. Acute tonsillitis and its complications: an overview /A. Bartlett, S. Bola, R. Williams //Journal of the Royal Naval Medical Service. - 2015. - №101(1). - P. 69-73.
3 Bastaki J. M. Necrotizing tonsillitis caused by group C beta-hemolytic streptococci //Ear, Nose & Throat Journal. - 2015. - №94 (3). - P. 23-26.
4 Blair A. B. A unifying theory of tonsillitis, intratonsillar abscess and peritonsillar abscess /A. B. Blair, R. Booth, R. Baugh //American journal of otolaryngology. - 2015. - №36(4). - P. 517-520.
Медицина и экология, 2017, 1
113
5 Casas L. Domestic use of bleach and infections in children: a multicentre cross-sectional study /L. Casas, A. Espinosa, A. Borràs-Santos // Occupational and environmental medicine. -2015. - V. 72(8). - P. 602-604.
6 Haighton C. Tonsillectomy or adenoton-sillectomy reduces the number of sore throats in children; however, insufficient information is available on the effectiveness in adults /C. Haighton, J. Wilson //Evidence Based Medicine. -2015. - V. 20 (2). - P. 64.
7 Huang Y. Low-temperature coblation tonsillectomy after peritonsillar abscess /Y. Huang, J. Ba, G. Wen //Journal of clinical otorhinolaryngolo-gy, head, and neck surgery. - 2014. - V. 28(23). - P. 1895-1896.
8 Iashan A. I. The character of variations in the relationships of lymphocyte subpopulations in the patients presenting with chronic decom-
pensated tonsillitis /A. I. Iashan, M. I. Gerasimi-uk //Vestnik otorinolaringologii. - 2015. - V. 2. -P. 27-30.
9 Koycu, A. idiopathic spontaneous tonsillar hemorrhage /A. Koycu, S. S. Erbek, H. S. Erbek //Kulak Burun Bogaz ihtisas Dergisi. -2015. - V. 25 (2). - P. 122-125.
10 Mazur E. Concurrent peritonsillar abscess and poststreptococcal reactive arthritis complicating acute streptococcal tonsillitis in a young healthy adult: a case report /E. Mazur, E. Czerwinska, A. Grochowalska //BMC Infectious Diseases. - 2015. - V. 15 (1). - P. 1.
11 Saltanova Z. H. Chronic tonsillitis, etiological and pathogenetic aspects of the development of metatonsillar complications //Vestnik otorinolaringologii. - 2015. - V. 80(3). - P. 65-70.
Received 11.01.2017
А. Ческа1, Т Сэндл2
СТРУКТУРНЫЕ АСПЕКТЫ ДИАГНОСТИКИ ТОНЗИЛЛИТА 1 Факультет медицины университета Трансильвании г. Брашов (Румыния), 2Университет Манчестера (Великобритания)
Представленное исследование демонстрирует структурные проблемы, связанные с различными формами тонзиллита, которые часто встречаются в клинической практике. В ходе исследования с использованием световой микроскопии изучали препараты, полученных путем обработки образцов, взятых из интраоперационных фрагментов. Для установки точного патологического диагноза необходимо проведение микроскопического исследования образцов.
Ключевые слова: тонзиллит, патология, микроскопия, анализ, диагностика
А. Ческа, Т Сэндл?
ТОНЗИЛЛИТДИАГНОСТИКАСЫНЫН К¥РЫЛЫМДЫК АСПЕКТЛЕР1
Брашов каласындаFы Трансильвания университетннн медицина факультет,/' (Брашов каласы, Румыния), 2Манчестер университет,/' (¥лыбритания)
¥сынылган зерттеу клиникалык тэж1рибеде жи1 кездесе™ тонзиллитщ эртурл1 формаларына байланысты курылымдык мэселелерд1 керсетед1. Зерттеу барысында жарык микроскопиясын пайдаланумен интраоперациялык фрагменттерден алынган Yлгiлердi ендеу жолымен алынган препараттар зерттелген. Анык патологиялык диагнозды белплеу Yшiн Yлгiлердi микроскопиялык зерттеу жYргiзу кажет. Клт сездер: тонзиллит, патология, микроскопия, анализ, диагностика
