An unusual cause of obstructive sleep apnea syndrome
This article reports a case of tonsil malignancy manifested as obstructive apnea syndrome. A 54‐year‐old male was referred to the ear, nose, and throat (ENT) department because of a 12‐month history of snoring, nocturnal waking, and chronic mouth breathing. The ENT clinical examination revealed a grade IV tonsillar hypertrophy, a major septal deviation, and a bilateral inferior turbinate hypertrophy.

According to the anatomical findings, a surgery (uvulopalatopharyngoplasty and tonsillectomy) was proposed and accepted by the patient. The patient underwent septoplasty, bilateral turbinate radiofrequency, and tonsillectomy. The macroscopic examination of the tonsils showed a 4 × 3.3 × 2.7 cm left tonsil weighted 5 g and a 6 × 4.4 × 2.9 cm right tonsil weighted 9 g. Both specimens showed an elastic consistency at section.

The patient underwent septoplasty, bilateral turbinate radiofrequency, and tonsillectomy. The histopathologic and immunohistochemical analyses concluded lymphocytic lymphoma/LLC‐B without signs of blastic transformation.

Tonsillar hypertrophy and related OSA is an extremely rare presentation of lymphoma since only two cases have been reported in the literature, both in children. Moreover, this case raises the important question of the systematic histopathologic analysis of resected specimens.

Read more: https://onlinelibrary.wiley.com/doi/full/10.1002/ccr3.2345
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