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    Related Topics

    From Lymphatic System

    Jugular Trunk
    Drains lymph from the head and neck.
    Mastoid Lymph Nodes
    Drain the posterior scalp and ear.
    Iliac Lymph Nodes
    Include external, internal, and common iliac nodes.
    SALT
    Skin-associated lymphoid tissue.
    Apical Axillary Nodes
    Located at the apex of the axilla.
    Lymphatic Capillaries
    Initial lymphatic vessels that collect interstitial fluid.
    MALT
    Mucosa-associated lymphoid tissue.
    Tubal Tonsils
    Near openings of the auditory tubes.
    Inguinal Lymph Nodes
    Drain the lower limbs and external genitalia.
    Occipital Lymph Nodes
    Drain the back of the scalp.
    NALT
    Nasal-associated lymphoid tissue.
    Supraclavicular Lymph Nodes
    Located above the clavicle; key in thoracic drainage.
    Lateral Axillary Nodes
    Located along the humerus in the axilla.
    Retroaortic Nodes
    Located behind the aorta.
    GALT
    Gut-associated lymphoid tissue.
    Intestinal Trunk
    Drains lymph from the intestines.
    Deep Cervical Lymph Nodes
    Located along internal jugular vein; receive lymph from head and neck.
    Cisterna Chyli
    Dilated sac at the start of the thoracic duct.
    Paratracheal Nodes
    Located lateral to the trachea.
    Palatine Tonsils
    Located on each side of the oropharynx.
    Submandibular Lymph Nodes
    Drain the face, mouth, and pharynx.
    Submental Lymph Nodes
    Drain the floor of the mouth and central lower lip.
    Thymus
    Primary lymphoid organ for T-cell maturation.
    Pharyngeal Tonsil
    Located in the nasopharynx (adenoids).
    Lumbar Trunk
    Drains lower limbs and pelvic organs.

    Lingual Tonsils

    Reviewed by our medical team

    Located at the base of the tongue.

    1. Overview

    The lingual tonsils are small, oval-shaped clusters of lymphoid tissue located at the base of the tongue. They are a component of the mucosa-associated lymphoid tissue (MALT) and a member of Waldeyer’s ring—a circular arrangement of lymphoid tissue that guards the entrance of the respiratory and digestive tracts. Lingual tonsils contribute to immune surveillance by detecting and responding to antigens entering through the oral cavity. Although less commonly inflamed than palatine tonsils, they play a key role in oropharyngeal immunity.

    2. Location

    The lingual tonsils are located on the dorsal surface of the posterior third of the tongue, behind the terminal sulcus and foramen cecum. Specific anatomical relationships include:

    • Anterior to: The epiglottis

    • Posterior to: The circumvallate papillae and terminal sulcus

    • Inferior to: The oropharynx

    Because they are embedded in the mucosa of the tongue’s base, they are not visible during a routine oral examination unless significantly enlarged or inflamed.

    3. Structure

    The lingual tonsils are made of diffuse and nodular lymphoid tissue arranged under a mucosal covering. Structural features include:

    • Epithelium: Covered by non-keratinized or partially keratinized stratified squamous epithelium, continuous with the tongue’s surface.

    • Crypts: Each tonsil contains one or more shallow crypts or pits, though less prominent than those in palatine tonsils, allowing antigen exposure.

    • Lymphoid follicles: Composed of B cells in germinal centers, surrounded by T lymphocytes, dendritic cells, and macrophages.

    • No capsule: Lingual tonsils are not encapsulated, allowing direct interaction between immune cells and the oral mucosal environment.

    These features facilitate rapid immune recognition and response to ingested or inhaled antigens.

    4. Function

    The lingual tonsils function as immunologic sentinels in the oral cavity. Their major functions include:

    • Antigen capture: Crypts and surface epithelium expose immune cells to antigens from food, saliva, and airborne particles.

    • Lymphocyte activation: Dendritic cells present antigens to T and B lymphocytes to trigger adaptive immune responses.

    • IgA secretion: B cells undergo class switching to produce IgA antibodies, critical for mucosal immunity.

    • Immune memory formation: Contributes to local and systemic immunological memory against encountered pathogens.

    5. Physiological Role(s)

    As part of the oropharyngeal immune system, the lingual tonsils serve several important roles:

    • First-line defense: Intercept pathogens entering via the mouth, especially during chewing and swallowing.

    • Maintenance of oral tolerance: Helps prevent immune overreaction to non-pathogenic antigens like food particles and commensal flora.

    • Coordination with Waldeyer’s ring: Works in tandem with the palatine, pharyngeal, and tubal tonsils to provide broad mucosal immunity.

    • Support during early immune development: In children, lingual tonsils help educate the developing immune system.

    6. Clinical Significance

    Lingual Tonsillitis

    Although less frequent than palatine tonsillitis, inflammation of the lingual tonsils—lingual tonsillitis—can occur. Symptoms include:

    • Sore throat localized to the base of the tongue

    • Pain with swallowing or speech

    • Foreign body sensation in the throat

    • Referral otalgia (ear pain)

    Causes may include bacterial (e.g., Streptococcus pyogenes) or viral infections, gastroesophageal reflux, or trauma from instrumentation (e.g., intubation).

    Obstructive Symptoms

    Hypertrophy of the lingual tonsils can contribute to:

    • Obstructive sleep apnea (OSA): Due to airway narrowing at the tongue base, especially in children or post-tonsillectomy patients.

    • Speech changes and dysphagia: Resulting from increased bulk at the tongue base.

    Lingual Tonsil Hypertrophy (LTH)

    LTH may occur as a compensatory mechanism following palatine tonsillectomy or adenoidectomy. It is often asymptomatic but can lead to complications such as:

    • Snoring or sleep-disordered breathing

    • Obstructed intubation (especially during anesthesia)

    Neoplasms

    Though rare, squamous cell carcinoma may arise in the lingual tonsils, especially in patients with a history of tobacco use or HPV infection. Presenting signs include a mass at the tongue base, persistent sore throat, or cervical lymphadenopathy.

    Diagnostic and Surgical Considerations

    • Visualization: Difficult to assess during physical exam; requires indirect laryngoscopy or flexible nasopharyngoscopy.

    • Tonsillectomy: Lingual tonsillectomy is rarely done but may be considered for chronic infection, hypertrophy, or malignancy.

    Did you know? The lymphatic system plays a significant role in the body's ability to heal itself after injury or infection.