Tonsillar tissue can occurs in other places then the expected tonsils and adenoids.
Tonsillar tissue is often found along the posterior lateral tongue and in the oro-pharynx, including the base of the
tongue. In the latter location, these patches are called lingual tonsils. The tonsils, adenoids & lingual tonsils
constitute Waldeyer's Tonsillar Ring (or Pharyngeal Lymphoid Ring). Ectopic tonsillar tissue has been found in
the orbit and nasal septum.
The occurrence of ectopic tonsillar tissue elsewhere in the oral cavity especially in the floor of the mouth (oral
tonsils), however, is less well known. When such lesions are small and not inflamed they do not attract attention.
However, when enlarged and erythematous (reddened) and tender or undergoing cystic change due to keratin
plugging, they may become noticed by the patient or the dentist or physician.
Lymphoid patches are to be regarded as physiologic rather than pathologic and can be seen in almost every
Enlargement of the lingual tonsils may occur after tonsillectomy, probably because of a compensatory
mechanism. In rare instances, lingual tonsillitis and even abscess formation may occur.
The diagnosis is usually based on clinical judgment. Only in doubtful cases is a biopsy indicated.
The benign lymphoid aggregate requires no treatment but may have to be excisionally biopsied in order to provide
an appropriate diagnosis and to rule out lymphoid or other malignancy.
- Diagnostic tests: None
- Biopsy: No, unless unilateral or otherwise suspicious
- Treatment: None
- Follow-up: None