Summary
The tonsils are a set of lymphoid organs facing into the aerodigestive tract, which is known as Waldeyer's tonsillar ring and consists of the adenoid tonsil, two tubal tonsils, two palatine tonsils, and the lingual tonsils. These organs play an important role in the immune system. When used unqualified, the term most commonly refers specifically to the palatine tonsils, which are two lymphoid organs situated at either side of the back of the human throat. The palatine tonsils and the adenoid tonsil are organs consisting of lymphoepithelial tissue located near the oropharynx and nasopharynx (parts of the throat). Humans are born with four types of tonsils: the pharyngeal tonsil, two tubal tonsils, two palatine tonsils and the lingual tonsils. The palatine tonsils tend to reach their largest size in puberty, and they gradually undergo atrophy thereafter. However, they are largest relative to the diameter of the throat in young children. In adults, each palatine tonsil normally measures up to 2.5 cm in length, 2.0 cm in width and 1.2 cm in thickness. The adenoid grows until the age of 5, starts to shrink at the age of 7 and becomes small in adulthood. The tonsils are immunocompetent organs which serve as the immune system's first line of defense against ingested or inhaled foreign pathogens, and as such frequently engorge with blood to assist in immune responses to common illnesses such as the common cold. The tonsils have on their surface specialized antigen capture cells called microfold cells (M cells) that allow for the uptake of antigens produced by pathogens. These M cells then alert the B cells and T cells in the tonsil that a pathogen is present and an immune response is stimulated. B cells are activated and proliferate in areas called germinal centers in the tonsil. These germinal centers are places where B memory cells are created and secretory antibody (IgA) is produced. The palatine tonsils can become enlarged (adenotonsillar hyperplasia) or inflamed (tonsillitis).
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