HYPERPLASIA OF THE TONSILS While hyperplasia of the faucial tonsils has long been a recognized condition, it is only since ISOS that the same anomaily of the pharyngeal tonsil has received attention. Wilhelm Meyer of Copenhagen, was the first to call attention to this condition which plays such an important riffe in the pathology of childhood.
hyperplasia as a rule involves all three tonsils equally. This enlargement of the tonsils either takes the form of a compact tumor-like, or polypoid, pedunculated swelling. The growth ntay be finn or soft. In the tonsillar crypts concretions made up of detritus and bacteria are frequently found. Microscopically. the struc ture of the soft tonsil is found to be simply lymphoid tissue, while in the firm tonsils there is a formation of connective tissue showing a previous chronic inflammation.
causes leading to tonsillar hyperplasia have not been definitely determined. One view is that the enlarged tonsil is the result of many attacks of acute inflammation; on the other hand it is believed that primary hyperplasia occurs, thi.s ti.ssue being particularly susceptible
to inflammatory processes. This view is undoubtedly the correct one. These hyperplasias occur independently of catarrhal or recurring inflam matory processes, and are probably due to a distinct predisposition, known as the "lymphatic constitution," on the part of the individual.
Tuberculous or scrofulous diatheses are not factors in such hyper plasias. Neither need they be necessarily regarded as a result of consti tutional weakness leading to catarrhal conditions of mucous surfaces (the exudative diathesis of Czerny).
There are many such susceptible children free from enlarged tonsils, and on the other hand many children with enlarged tonsils who are not susceptible to catarrhal conditions.
It is better to consider tonsillar hyperplasia as the expression of an increased tendency to the formation of lymphoid tissue during childhood.