Reactive Follicular & Paracortical Immunoblastic Hyperplasia in Tonsils

Lessons From the Friday Unknowns

The patient presented with severe throat pain, cold-like symptoms and headache. COVID and influenza testing was negative.

The tonsils show reactive follicular hyperplasia and expansion of the interfollicular regions by plasma cells and immunoblasts. In some areas the immunoblasts form clusters and sheets. Surrounding the tonsils are areas of acute inflammation, necrosis and hemorrhage that are particularly prominent surrounding the…