[Histonet] Re: Submission of tonsils to Pathology

[Robert Richmond]

I have no idea how many tonsils I've looked at since finishing
residency in 1972, but I haven't seen a clinically significant
diagnosis made on a tonsillectomy specimen since then.

In residency at Johns Hopkins around 1970, I did see two significant
diagnoses made. I made the diagnosis of tuberculosis on a two year old
child myself - we were actually able to stain the organisms. I don't
know the follow-up. - Somebody else made a diagnosis of lymphoma on a
child's tonsil, but I suspect the diagnosis was wrong.

The question for the pathologist is entirely one of revenue.

But to enlarge the question of revenue - children in great numbers are
still being subjected to this painful and hazardous procedure - I
still see tonsillectomy specimens the same day and same last name
(from siblings, I mean) very frequently. If we really want to save the
health care system money, we need to greatly reduce the number of
tonsillectomies done. It's basically an ethnosurgical procedure, like
circumcision and ear piercing.

Bob Richmond
Samurai Pathologist
Knoxville TN