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What Causes Elongated Tonsil?

Posted on Mon, 29 Sep 2014

Question: when looking at my left tonsil, I noticed that is has either elongated down my throat along the side and/or it is the lingual tonsil growing upward???? Is this due to allergies? Of course, my first thought is cancer but I am too petrified to have it looked at. When I stick my tongue all the way out and turn the tongue to the opposite side and look at the back of the tongue on the side (near teeth) there is slightly more "tissue" on that side then on the right side. Is that "tissue" what I am seeing when looking at my tonsil? I have pictures, should I include them?

Answered by Dr. Naveen Kumar Nanjasetty (3 hours later)

Brief Answer:
The lesion is neither cancer nor lingual tonsil...

Detailed Answer:
Hi

Thanks for posting the query and an elaborate history.

I have examined the image thoroughly after zooming.

Correlating the history and the image findings, I am of the opinion that it is neither lingual tonsil nor cancer. Lingual tonsils are present behind the tongue, but not on the side. Secondly, the cancer of the tongue is an exophytic growth i.e. a projecting growth. But, in your case, it's the normal soft tissue present on the side of the tongue.

To further explain in detail about cancer of the tongue. Cancer of the tongue is a rapidly growing tumor which can spread to the adjacent structures within no time. In your case it is seen since four years which is a pretty long time. Hence, the cancer in this particular area is ruled out.

Allergic lesions are usually seen either below the tongue or in the posterior pharyngeal wall.

Finally, I would like to bring it to your attention that there seem to be a small ulceration on the left side of the tongue which needs to be observed.

Hope I have answered your query; I will be available for the follow up queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Naveen Kumar Nanjasetty (54 minutes later)

Thank you Dr. XXXXXXX for addressing my questions. I do have follow up questions. Specifically what "ulceration" on the left side of the tongue are you referring to? Is it possible for you to draw an arrow or circle it? Second, why is the "tissue" on the side of the tongue that I am referring to more pronounced on that side and not the other side? Why is it that when I open my mouth and look at my left tonsil it goes down the side of the throat and the other tonsil doesn't?Also wanted to mention that what I have seen for 4 years was the tonsil tissue on the left side going down the side of the throat, I only recently looked at the back of my tongue and saw what was in the photo you received. I thought what I saw on the side of my tongue was what I was seeing when I was looking down my throat...is that true or false?

Answered by Dr. Naveen Kumar Nanjasetty (1 hour later)

Brief Answer:
There is no abnormality seen...

Detailed Answer:
Hi XXXXXXX

Thanks for writing back

1. The ulcer I'm concerned about, is placed perpendicular to the forward tip of the line drawn by you, over the teeth. I presume it to be a small ulceration, secondary to the friction caused by the sharp inscisor and the premolars. I'm sorry, I can't mark it on the image and upload it to you along with this query, as I don't have option to do that. If you can provide me your Email I D, I can upload the marked image for you.

2. The soft tissue you are referring to is not related to the tonsil. Tonsil is situated far behind this soft tissue swelling. The disparity in the size of the tonsillar swellings is due to presence of crypts. In certain individuals, the deeper crypts divide the tonsil into multiple lobes making it appear as if there is a growth present over the tonsil.

3. To be honest, I am not seeing anything abnormal in the image sent by you. Trust me, cancer doesn't stay so long without causing pain or bleeding.

Wish you good health

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon

Note: For further information on diet changes to reduce allergy symptoms or to boost your immunity, Ask here.

Above answer was peer-reviewed by : Dr. Raju A.T