Hi,

Thank you for your query.

1. Tonsilloliths are concretions of food particles and pus lodged in the natural crypts of the palatine tonsils. The white discharge is sometimes referred to as 'cheesy' or even 'toothpaste' like in consistency. The largest crypt is known as the crypta magna and is located near the upper pole of the palatine tonsil.

2. When we swallow, our palatine tonsils rub against the food bolus and pick up food particles. This food debris decays there while it is analysed for antigens, foreign bodies and organisms by the lymphoid tissue which forms the bulk of the tonsils. Below the age of five years, this is especially important in the deveopment of immunity.

3. Rarer still will be the possibilty of a recurrent small abscess in the peritonsillar space. However this would be unusual without local inflammation and lymph node tenderness in the neck.

4. For recurrent large tonsilloliths or peritonsillar abscesses, the only definitive treatment is tonsillectomy.

I hope I have answered your query. Please reply back with the answers and I will be able to help you further.

Regards.

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Hi,

Thank you for writing back.

1. With pus draining out and an enlarged lymph node the chances of local infection is much more than a throat cancer.

2. Cancer at your age is not common, hence the chances of detecting cancer is very low. If this subsides with antibiotics and anti-inflammatory medication, the it is not cancer.

3. If in doubt, a simple biopsy from the upper tonsil area where the pus drained out and an FNAC (Fine Needle Aspiration Cytology) of the enlarged lymph node will settle the issue. Sonography of the neck may also help to locate the lymph node if the lymph node is very small.

I hope I have answered your query. Please reply back with the answers and I will be able to help you further.

Regards.

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