Читать книгу The Esophagus - Группа авторов - Страница 160

Lymphoid hyperplasia is a nonspecific response to aging, allergies, and repeated infections, involving the palatine tonsils (Figure 6.22) or base of the tongue [42]. Lymphoid hyperplasia of the lingual tonsil may also occur as a compensatory response to prior tonsillectomy. Lymphoid hyperplasia may extend into the valleculae, vallecular surface of the epiglottis, or even the proximal hypopharynx. There are no radiographic criteria for differentiating lymphoid hyperplasia of the tongue base from the normal lingual tonsil. Lymphoid hyperplasia is characterized on barium studies by numerous 3–7 mm smooth‐surfaced, ovoid nodules symmetrically distributed over the vertical surface of the tongue [42, 43] (Figure 6.23). These nodules may protrude posteriorly into the oropharynx and valleculae. When lingual tonsil lymphoid hyperplasia is focal or mass‐like, it can mimic the appearance of tumor at the base of the tongue [42]. Patients with asymmetric nodularity or mass lesions at the tongue base therefore should undergo further investigation to differentiate lymphoid hyperplasia of the lingual tonsil from malignant tumor.