On the Rheumatic Granulomas of the Tonsil

Abstract

A histopathological study of faucial tonsils was made after tonsillectomy in patients suffering from chronic tonsillitis and from rheumatism in different stages of the rheumatic process (current attack, abating attack, quiescent periods between rheumatic attacks). Rheumatic granuloma, in different stages of development was found only in patients admitted into hospital with an acute phase of rheumatism. Tonsillitis preceding the rheumatic attack was a necessary condition for the detection of rheumatic granuloma; acuteness and intensity of the rheumatic process at the time of tonsillectomy were also of significance. Antirheumatic therapy administered to the patient prior to tonsillectomy contributes to the disappearance of rheumatic granulomas in the faucial tonsils; the character of treatment (hormones or salicylates) however is of no essential importance in this respect. The early stages of granuloma (disorganisation of the paraplastic substance, a well defined lymphoid zone) may be considered as a criterion of the activity of the rheumatic process. Macrophagal (histiocytic) infiltrates in the tonsillar capsule, as well as the changes in the blood-vessels are apparently a manifestation of a hyperergic reaction of the body to the rheumatic agent.