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Clinical Problem Solving: Pathology
October 2002

Diagnosis Pathology Quiz Case 2

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2002;128(10):1212. doi:

Lymphangioma of the palatine tonsil is a rare finding. To our knowledge, only 27 reported cases exist in the English-language literature.1,2 A tonsillar lymphangioma may be discovered routinely, during physical examination, or intraoperatively, during tonsillectomy. It is a benign lesion characterized grossly by its smooth tan-white surface. Microscopically, it has a dense submucosal stroma with dilated lymphatic spaces lined by endothelium and occasionally containing intraluminal lymphocytes. Lymphangiomas of the tonsil differ from lymphangiomas found elsewhere, in that they contain a greater degree of dense connective tissue.3 The list of differential diagnoses for lesions with this type of histologic and clinical appearance includes lymphangioma, lymphangiectasia, hemangioma, and arteriovenous malformations.