[Bilateral tonsillar hypertrophy as the first manifestation of B cell-small lymphocytic lymphoma with interfolicular pattern].

B-cell small lymphocytic lymphoma typically involves nodal or extranodal tissues as a diffuse proliferation with proliferation centers (pseudofollicules) obliterating normal architecture. But there are unusual patterns of involvement including interfollicular pattern that can be difficult to recognize histologically and probably represent partial or early involvement by neoplasm. Tonsillar lymphoma usually presents either as a unilaterally enlarged palatine tonsil or as an ulcerative and fungating lesion over the tonsillar area. Most lymphomas that involve the tonsil are diffuse large B cell lymphomas and primary low-grade lymphomas are exceptional. We present a primary B-cell small lymphocytic lymphoma affecting palatine tonsils with interfollicular pattern in a 54 year-old man that clinically presented with symmetric / bilateral tonsillar enlargement and sleep apnea.