Evaluating the Utility of Routine Tonsil Pathology in a Safety-Net Hospital: Low Yield of Unexpected Malignancies Supports Risk-Stratified Approach

Highlight

• In a safety-net hospital setting, routine histopathological examination of tonsillectomy specimens rarely detects unexpected malignancies.
• All pediatric tonsil specimens showed no malignancy, indicating limited utility of routine pathology in children without clinical suspicion.
• Preoperative clinical and radiographic assessment effectively triaged patients, with 95% of adult malignancies anticipated or suspected prior to surgery.
• Findings support risk-stratified pathology protocols rather than universal histologic evaluation, optimizing resource use without compromising patient safety.

Study Background