Histopathological Reporting of Actinomyces Colonies in Tonsils-Utility or Futility? A Retrospective Study
Introduction: Actinomyces colonies in tonsillectomy specimens are often ignored as commensals and histopathology reports do not carry any information about them. But evidence suggests that under favourable conditions these may become invasive and pathogenic, serving as precursors to later system...
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| Autores principales: | , , , |
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| Formato: | article |
| Lenguaje: | EN |
| Publicado: |
JCDR Research and Publications Private Limited
2021
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| Acceso en línea: | https://doaj.org/article/65208d67c72f4948bb87e55b848c4f57 |
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| Sumario: | Introduction: Actinomyces colonies in tonsillectomy specimens
are often ignored as commensals and histopathology reports do
not carry any information about them. But evidence suggests
that under favourable conditions these may become invasive
and pathogenic, serving as precursors to later systemic disease.
Early identification of mucosal breach by these bacteria may
have a role in the clinical management and future prognosis.
Aim: To determine the frequency of occurrence of Actinomyces
colonies in tonsillectomy specimens and study the various
associated histological alterations which may provide a clue to
their pathogenicity.
Materials and Methods: This was a retrospective study on 140
tonsillectomy specimens, from 70 patients who had undergone
elective, bilateral tonsillar surgery. Tonsils were examined for
Actinomyces colonies and histological alterations as per two
different grading criteria. Different clinicopathological features
were associated, those with and without Actinomyces colonies
using appropriate statistical tools (t-test, Chi-square and
Fisher’s exact test; Statistical Package for the Social Sciences
{SPSS} version 23.0).
Results: A total of 140 tonsillar tissue specimens were analysed
from 70 patients and divided into two groups Group 1 (with
actinomycosis) and Group 2 (without actinomycosis) with a mean
age of 13.6±6.63 years and 11.8±7.19 years, respectively. The
frequency of Actinomyces colonies was found to be 40% (28 of
70 patients) with bilateral presence in 28.5% (8 of 28 patients).
Tissue reaction was present in 36.11% (13/36 tonsillar specimens)
of the tonsillectomy specimens harbouring Actinomyces. Deeply
situated colonies elicited tissue reaction more frequently
(11/19 tonsillar specimens; 57.89%) compared to superficial ones
(2/17 tonsillar specimens; 11.76%). Tonsillar cryptitis was the
most statistically significant histopathological finding associated
with the presence of Actinomyces colonies (p=0.029).
Conclusion: Tonsillar cryptitis was found to be a consistent
histological finding in tonsillar actinomycosis. The frequent acute
inflammatory responses generated by deeply located Actinomyces
colonies refutes their role as mere commensals. It is suggested that
tonsil histopathology reports should mention the presence/ location/
tissue reaction surrounding Actinomyces colonies to differentiate
mere colonisation from invasion. This could have profound clinical
implications in terms of necessity of antibiotic use for prophylaxis/
and or treatment. |
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