ABSTRAKRuang Lingkup dan Cara Penelitian: Hubungan antara jenis kelainan histopatologik tertentu pada radang berulang tonsil dengan kelainan imunopatologik yang terjadi belum banyak diselidiki. Penelitian ini ditujukan untuk melihat hubungan antara kelainan histopatologik tertentu dengan kelainan imunopatologik yang timbul dengan jalan menghitung jumlah dan penyebaran set pengandung imunoglobulin (SPIg) pada tonsil serta mengukur kadar imunoglobulin serum pada penderita radang berulang tonsil. Diperiksa 125 pasang tonsil dan serum yang berasal dari 125 anak usia 4-14 tahun yang menjalani tonsilektomi. Dengan pewarnaan HE dilakukan penggolongan jenis kelainan histopatologik. Dengan cara imunoperoksidase (PAP) diperiksa jumLah SPIg (keLas G,M,A,E dan D) pada daerah sentrum germinativum (SG), kelim limfosit (KL), interfolikuler (IF) dan epitel retikuler kripta (ER). Dengan cara imunodifusi radial diperiksa kadar imunoglobulin (kelas G,M dan A) dalam serum penderita. Sebagai perbandingan diperiksa kadar Ig serum yang berasal dari 33 anak sehat dengan tonsil yang tidak menunjukkan tanda radang.HasiL dan Kesimpulan: Secara histopatologik ditemukan jenis kelainan yaitu: hiperplasia tonsil (HT), 60,5 %; tonsilitis kronik .(TK), 23,2% dan tonsilitis kronik eksaserbasi akut (IKEA), 16,0%. Jumlah SPIg di daerah KL pada kelompok TK Lebih banyak dan berbeda bermakna dibandingkan dengan kelompok TKEA dan HT. Di daerah ER, jumlah SPIg pada kelompok TK Lebih sedikit dan berbeda bermakna dibandingkan keLompok TKEA. Ditemukan peningkatan bermakna kadar Ig G dalam serum pada kelompok TK dan HT dibandingkan dengan keLompok kelola, dan peningkatan bermakna kadar Ig A dalam serum penderita TK dibandingkan dengan kelompok kelola. Perbedaan jumlah dan penyebaran SPIg pada tonsil yang mengatami radang berulang sesuai dengan jenis kelainan histopatoLogik, yang diikuti dengan peningkatan kadar Ig G dan Ig A dalam serum.

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ABSTRACT

Scope and Method of Study: The relationship between histo pathological and immunopathological changes caused by recurrent inflammation of the tonsil has not been studied extensively. The aim of this study was to see the relationship between particular histopathological changes by counting the immunoglobulin containing cells (Ig CC) and its distribution in tonsil and to measure immunoglobulin (Ig) Level in serum of patients with recurrent inflammation of the tonsil. One hundred and twenty five pairs of tonsils and 125 sera from children aged 4-14 years, who underwent tonsillectomy were examined. Histopathological diagnosis was based on routine H and E staining. Immunoperoxidase (PAP) staining was performed to count the amount and distribution of Ig CC (G,M,A,E and D classes) in germinal center (GC), Lymphocyte cuff (LC), interfoLlicular (IF) and reticular part of epithelium (RE) areas. Ig (G,M and A) serum Levels were measured by radial immunodiffusion technique. As a comparison, Ig serum levels of 33 healthy children without signs of inflammation of the tonsil was examined.

Findings and Conclusions: Three histopathological changes were found: hyper plastic tonsil (HT), 60.8%; chronic tonsillitis (CT), 23.2% and chronic tonsillitis with acute exacerbation (CTAE), 16.0%. Significantly higher proportion of Ig CC in LC area was found in CT group compared to CTAE and HT groups. In contrast, in RE area the proportion of Ig CC in CT group was significantly Lower than in CTAE group. There were significant elevations of Ig G serum level in CT and HT groups compared to the control group. Ig A serum Level in CT group was significantly higher than the control group. This study revealed that Ig G CC have different distribution in inflamed tonsil according to its histopathological changes, and those changes were accompanied by the increase of Ig G and Ig A serum Levels.