Tonsils only present as "white lumps" if they are inflamed or infected with symptoms of exudates (pus drainage) and severe swelling.

The palatine tonsil is one of the mucosa-associated lymphoid tissues (MALT), located at the entrance to the upper respiratory and gastrointestinal tracts to protect the body from the entry of exogenous material through mucosal sites.

The glossopharyngeal nerve continues past the palatine tonsil and innervates the posterior 1/3 of the tongue to provide general and taste sensation.

[9] Tonsillar (relating to palatine tonsil) B cells can mature to produce all the five major immunoglobulin (Ig, aka antibody) classes.

In addition to humoral immunity elicited by tonsillar and adenoidal B cells following antigenic stimulation, there is considerable T-cell response in palatine tonsils.

It has been reported by many studies that the clinic outcome of many infectious, autoimmune, or malignant diseases appears to be influenced by the overall balance of production (profiles) of pro-inflammatory and anti-inflammatory cytokines.

Therefore, determination of cytokine profiles in tonsil study will provide key information for further in-depth analysis of the cause and underlying mechanisms of these disorders, as well as the role and possible interactions between the T- and B-lymphocytes and other immunocompetent cells.

The pathogenesis of infectious/inflammatory disease in the tonsils most likely has its basis in their anatomic location and their inherent function as organ of immunity, processing infectious material, and other antigens and then becoming, paradoxically, a focus of infection/inflammation.

Viral infection with secondary bacterial invasion may be one mechanism of the initiation of chronic disease,[11] but the effects of the environment, host factors, the widespread use of antibiotics, ecological considerations, and diet all may play a role.

[12] A recent cross-sectional study revealed a high rate of prevalent virus infections in non-acutely ill patients undergoing routine tonsillectomy.

[14][15] The information that is necessary to make a rational decision to resolve this controversy can be obtained by understanding the immunological potential of the normal palatine tonsils and comparing these functions with the changes that occur in the chronically diseased counterparts.