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How to check for tonsil cancer?

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ENT Specialist
Practicing since : 1991
Answered : 2444 Questions
Bottom of left tonsil is 'ball like'? bigger than the right tonsil. large crypts on the upper portion of left tonsil, I have been told I do not have an infection nor do I see any tonsilar stones, bad breath, GERD............ normal cbc...... normal BMP, no night sweats, or extreme fatigue, no weight loss....., non smoker, I do have lupus.... can this be lymphoma?
Posted Sun, 23 Feb 2014 in Ear, Nose and Throat Problems
Answered by Dr. Sumit Bhatti 1 hour later
Brief Answer: There is no cause for worry. Detailed Answer: Hi, Thank you for your query. 1. It is not uncommon for tonsils to appear like your description above. The largest tonsil crypt is at the upper pole (crypta magna). 2. Tonsil cancers or lymphomas are rare and are accompanied by multiple symptoms as you have mentioned. Hence this is unlikely. 3. The only way to confirm would be a biopsy. This was never done earlier as tonsil tissue bleeds torrentially when partially cut. Now with newer surgical tools such as coblation and laser, it is possible, but only under general anesthesia. You may get a Neck Ultrasound done to look for any local lymph nodes. If these are absent, lymphoma is highly unlikely. 4. If you have no symptoms, regular observation and follow up will help. If you have a foreign body sensation, tonsillectomy is an option. 5. One more option is to get a throat swab or scraping checked for viral DNA linked to oral cancers, such as HPV types 16,18 and Ebstein Barr Virus (EBV). If these are negative, there is no cause for worry. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.
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Follow-up: How to check for tonsil cancer? 1 hour later
I also get this burning sensation on my tongue and cheek in the back of my mouth and I noticed I have 4 red pinpoint dots on my soft palate way in the back- I DO have gerd. . . . I did get checked for EBV about 5 months ago that was negative . by chance can GERD make one tonsil swell?
Answered by Dr. Sumit Bhatti 11 minutes later
Brief Answer: As below: Detailed Answer: Hi, Thank you for writing back. 1. Yes, that is possible. 2. If you have mucosal lesions, it is a possible that GERD or LPR (Laryngo Pharyngeal Reflux) is a cause. 3. Besides the acid, digestive enzymes are also present in the reflux. These also irritate the throat whenever the pH falls. 4. This may not explain why one tonsil is swollen. Sometimes it may be a response to an old foreign body, inflammation or infection. Lymphoid tissue does not regress to its earlier size. The tonsils usually scrape up food tissue and foreign bodies while swallowing. I hope that I have answered your query. If you have any further questions, I will be available to answer them. Regards.
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