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What Does This Pathology Report Indicate?
Question: Last month I underwent a tonsillectomy, UPPP, turbinoplasty, septolasty, and radiofrequency ablation of the tongue to correct obstructive sleep apnea. The ENT physician who performed my surgery informed me at my follow-up appointment a week later that actinomyces colonization of the left tonsil was found. I was not told that this would require a course of treatment. However, everything I have read regarding actinomycosis indicates that this type of infection requires treatment.
I don't have chest pain, fever, weight loss or coughing. However, when I bite down a little on the anterior part of the tongue just before the tip, I feel like I am biting down on very tiny cysts embedded within the tongue which is something i did not have prior to the surgery. In the past week to 10 days I have developed a ring of white material with a grayish border at the site of the UPPP (i.e., where the soft palate tissue was removed). Also, at the very back of the tongue there is a grayish white film and raised, hardened bumps that are difficult to brush away.
My question is, are there cases of actinomycosis that do not require treatment and is this one of them or should I visit my PCP (or ENT) for follow-up?
Following are the results of the pathology report that were made available to me through the hospital's patient portal:
-- Diagnosis --
1. RIGHT TONSIL, TONSILLECTOMY:
-ACUTE AND CHRONIC TONSILLITIS.
2. LEFT TONSIL AND SOFT PALATE, TONSILLECTOMY AND EXCISION:
-ACUTE AND CHRONIC TONSILLITIS WITH ACTINOMYCES COLONIZATION.
-BENIGN SQUAMOUS MUCOSA.
Clinical Information
Operative Findings: RIGHT TONSIL, LEFT TONSIL WITH SOFT PALATE
Source of Specimen
1: RIGHT TONSIL
2: LEFT TONSIL WITH SOFT PALATE
Gross Description
1. "--------, RIGHT TONSIL" Disrupted tonsil with tonsil
fragments, 4 grams and 3.5 x 3.2 x 1.5 cm in aggregate. Sectioning
reveals clefted tan-pink cut surfaces with no masses. Representative
sections 1cs.
2. "---------LEFT TONSIL WITH SOFT PALATE" 4 gram, 4.2 x 2.5 x
1.5 cm tonsil with a clefted tan-pink cut surface and no masses.
Separate, is a 2.5 x 1.5 x 1.5 cm portion of gray-tan tissue
consistent with soft palate and a few XXXXXXX rubbery fragments, 1.0 x 0.8
x 0.5 cm. No masses are seen. Representative sections 1cs. tm
I don't have chest pain, fever, weight loss or coughing. However, when I bite down a little on the anterior part of the tongue just before the tip, I feel like I am biting down on very tiny cysts embedded within the tongue which is something i did not have prior to the surgery. In the past week to 10 days I have developed a ring of white material with a grayish border at the site of the UPPP (i.e., where the soft palate tissue was removed). Also, at the very back of the tongue there is a grayish white film and raised, hardened bumps that are difficult to brush away.
My question is, are there cases of actinomycosis that do not require treatment and is this one of them or should I visit my PCP (or ENT) for follow-up?
Following are the results of the pathology report that were made available to me through the hospital's patient portal:
-- Diagnosis --
1. RIGHT TONSIL, TONSILLECTOMY:
-ACUTE AND CHRONIC TONSILLITIS.
2. LEFT TONSIL AND SOFT PALATE, TONSILLECTOMY AND EXCISION:
-ACUTE AND CHRONIC TONSILLITIS WITH ACTINOMYCES COLONIZATION.
-BENIGN SQUAMOUS MUCOSA.
Clinical Information
Operative Findings: RIGHT TONSIL, LEFT TONSIL WITH SOFT PALATE
Source of Specimen
1: RIGHT TONSIL
2: LEFT TONSIL WITH SOFT PALATE
Gross Description
1. "--------, RIGHT TONSIL" Disrupted tonsil with tonsil
fragments, 4 grams and 3.5 x 3.2 x 1.5 cm in aggregate. Sectioning
reveals clefted tan-pink cut surfaces with no masses. Representative
sections 1cs.
2. "---------LEFT TONSIL WITH SOFT PALATE" 4 gram, 4.2 x 2.5 x
1.5 cm tonsil with a clefted tan-pink cut surface and no masses.
Separate, is a 2.5 x 1.5 x 1.5 cm portion of gray-tan tissue
consistent with soft palate and a few XXXXXXX rubbery fragments, 1.0 x 0.8
x 0.5 cm. No masses are seen. Representative sections 1cs. tm
Brief Answer:
POST OPERATIVE ORAL INFECTION
Detailed Answer:
Hi
Welcome to HealthcareMagic and thanks for putting up the query
I have read the details. As the histopathology specimen shows actinomyces colonization, it should not be ignored. You can get a throat swab for culture sensitivity done to see if there is any infection.
The whitish deposit on the suture line post surgery is usually normal. It is just the oral debris. If there is any pain or soreness than it should be considered otherwise just use betadine gargles daily. This debris will clean in few days. THE bumps on the tongue is probably a healing reaction from ablation. Wait for At least 3 weeks. These all are healing reactions and will ward off soon.
Please get a throat swab for culture sensitivity done and send me the reports. If throat swab comes out to be positive than only antifungal treatment is to be given. For prophylaxis you can use antifungal mouth paint.
Any further questions are always welcome.
Wishing you a speedy recovery.
Thanks and regards
POST OPERATIVE ORAL INFECTION
Detailed Answer:
Hi
Welcome to HealthcareMagic and thanks for putting up the query
I have read the details. As the histopathology specimen shows actinomyces colonization, it should not be ignored. You can get a throat swab for culture sensitivity done to see if there is any infection.
The whitish deposit on the suture line post surgery is usually normal. It is just the oral debris. If there is any pain or soreness than it should be considered otherwise just use betadine gargles daily. This debris will clean in few days. THE bumps on the tongue is probably a healing reaction from ablation. Wait for At least 3 weeks. These all are healing reactions and will ward off soon.
Please get a throat swab for culture sensitivity done and send me the reports. If throat swab comes out to be positive than only antifungal treatment is to be given. For prophylaxis you can use antifungal mouth paint.
Any further questions are always welcome.
Wishing you a speedy recovery.
Thanks and regards
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
Above answer was peer-reviewed by :
Dr. Prasad
Answered by
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