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Ear, Nose, and Throat Disorders

Dilated blood vessels in the tonsils

09/24/2009

Question:

My 3 yr old daughter has +2 size tonsils. I had her evaluated by her pediatrician because I had noticed that there were blood vessels on the surface of her right tonsil which also looked bigger than the left side. This was about 4 months ago. Her Doctor did not seem concerned as I was, he said it was most likely a hemangioma and dictated it mesuring 1mm. 3 Days after she was evaluated a blood vessel had broken in that same tonsil. Other than the blood vessels, the tonsils look normal in appearance. There are no white patches, spots and no redness. I have been checking them regularly and have now noticed there are more visible blood vessels on the surface of her tonsil and now has them on the left tonsil as well. The particular blood vessel that her Doctor had said was 1mm, looks now larger and protrudes out farther than the rest of them. He also did the exam with her standing up and not laying down so the tonsils lay differently, so I don`t think he had seen the total picture. He made me feel silly even questioning and being concerned about it because we have blood vessels all over our body. So I have not taken her back in due to feeling like an idiot even though I truley am concerned. I am not sure if this has any relevance but my daughter does complain of pains all over her body which is mostly during the morning & evening and sporadically during the day. She does not sleep well (never has), but still is quite active during the day and will only make complaints about her back, arms, legs, hands, feet & belly. During her lifetime, she has only had 2 minor colds. She has been pretty healthy that way. I have tried to do some research looking on the internet, I have never seen a picture of tonsils that look like hers nor anywhere stating that this is normal. I wonder if this is something that I really should get a second opinion on or if it would be something I should just wait and watch. Side note; she does have a hemangioma on her lower back that has been there since birth.

Answer:

This does not sound like a hemangioma, but rather, a variant of normal. However, a second opinion would be appropriate.

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Response by:

Charles Monroe Myer III, MD Charles Monroe Myer III, MD
Professor of Otolaryngology
College of Medicine
University of Cincinnati