Tonsil-like lymphoid tissue may be present in the base of the tongue. Normally the lymphoid tissue is ill-defined and present in small masses a few millimeters in diameter. This tissue may become enlarged for a number of reasons, causing problems for the patient.
Conditions causing enlargement of the lingual tonsil:
(1) reactive lymphoid hyperplasia, often in conjunction with hyperplasia of the tonsils and adenoids
(2) drug-induced lymphoid hyperplasia (phenytoin, other)
(3) hyperplasia in response to reflux disease or recurrent vomiting (as in bulimia)
(4) obesity
(5) bacterial abscess
(6) tuberculosis or deep fungal infection
(7) thyroglossal duct cyst
(8) vascular malformation (varicosities)
(9) amyloidosis
(10) benign soft tissue tumor
(11) malignant lymphoma
(12) primary carcinoma (mucoepidemoid, squamous, other)
(13) metastatic carcinoma
