What could cause a white lump on the tonsil in someone with recurrent throat infections? (photo)

Doctor's Answers 3

Tonsils are two ovoid-shaped tissues at the back of your throat. They are part of your immune system but play a much smaller role compared to other immune organs such as your liver, spleen, lymphatic system and bone marrow.

From the picture provided, you have a benign looking cystic swelling on your left tonsil, which is likely a tonsillar cyst. This can occur after a tonsil infection and is due trapped mucous/saliva. I would suggest having the lump assessed by an ENT Specialist to ensure that there are no suspicious features for a more serious condition such as cancer (e.g. hard, irregular consistency of the lump, associated neck nodes etc). Benign cysts which does not cause symptoms can be left alone.

I'm sorry to hear that you have been having frequent tonsil infections for 10 years. If your tonsils are problematic, you may consider having them removed surgically (procedure is called tonsillectomy). Studies have shown that tonsillectomy does not weaken your immune system. Common reasons to have your tonsils removed include:

1. Frequent or recurrent tonsil infections

2. Large tonsils causing snoring or sleep apnoea

3. Growths suspicious for cancer or asymmetrically enlarged tonsils (which may mimic lymphoma - cancer of the lymph nodes)

4. Frequent tonsoliths (food or calcium deposits stuck in tonsillar crypts which may cause bad breaths).

Tonsillectomy is performed through the mouth under general anaesthesia (patient put to sleep during the procedure) with no external cuts (on the face or neck region). It is a relatively safe procedure and is one of the most common surgeries performed by an ENT Specialist.

The most common potential complication from a tonsillectomy is bleeding (~ 5% chance in the first 2 weeks after the surgery). Most of the time, bleeding from the tonsillar wound can be stopped in the clinic. Occasionally, a patient may have to be brought back to the operating theatre to stop the bleeding. It would be best to discuss your condition with your ENT Specialist.

Hope this helps and all the best!

From your photo, that white lump on your left tonsil looks like a mucous cyst (collection of trapped secretions from your tonsil glands). It may also be a tonsil stone. Both these conditions are commonly seen in people who suffer recurrent episodes of tonsil infections, such as yourself.

The fact that you have suffered from nasty tonsil infections for so many years puzzles me as to why you have chosen to continue to do so, when there is a relatively straightforward solution: remove those tonsils as they are the source of your infections! Repeat courses of antibiotics often fail to help as many cases of tonsillitis are virally-caused and instead only lead to growth of antibiotic-resistant organisms (“bugs”).

If you didn’t have such a turbulent history with tonsil infections, then these benign mucous cysts or tonsil stones may be left alone. But in your case, it sounds like it might be worth considering having your tonsils removed in a tonsillectomy procedure.

Many of my patients have experienced your situation, and gone on to have their tonsillectomy without problems. It may be done as a daycase though most patients prefer to stay overnight in hospital. The main risk of a tonsillectomy is postop bleeding due to secondary infection but in the right hands, this is rather low 1-2%. The other postop issue is sore throat but again, those patients who suffered from bad tonsil infections like yourself usually find their postop pain isn’t as bad as their pain caused by the tonsillitis episodes.

Take care and hope you recover soon.

The white “stuff” is actually not a lump but a food particle or food residue stuck within the tonsils deep crypts. These food residues may solidify and form “stones”, also known as tonsil stones or tonsilloliths.

Similar Questions

What are possible causes of a growing lump on the tonsil?

Oh dear, that does sound rather worrying to have a lump growing bigger on your tonsil! Most tonsil lumps tend to be benign however, such as an area of infection, scarred tissue for even a tonsil stone. It’s a pity you don’t have a photo for us to take a look at. But in view of its enlarging size and the fact that is is just on one side, I would strongly advise you to have it thoroughly checked out by an ENT specialist.

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Should I be worried if one of my tonsils is bigger than the other?

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