Evaluating the Utility of Routine Tonsil Pathology in a Safety-Net Hospital: Low Yield of Unexpected Malignancies Supports Risk-Stratified Approach

In a safety-net hospital setting, routine histopathological examination of tonsillectomy specimens rarely detects unexpected malignancies.
All pediatric tonsil specimens showed no malignancy, indicating limited utility of routine pathology in children without clinical suspicion.
Preoperative clinical and radiographic assessment effectively triaged patients, with 95% of adult malignancies anticipated or suspected prior to surgery.
Findings support risk-stratified pathology protocols rather than universal histologic evaluation, optimizing resource use without compromising patient safety.

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