Waldeyer's ring is the circle of lymphoid tissue that guards the entrance to the throat. It is made up of the pharyngeal tonsil (adenoids) above, the tubal tonsils at the sides of the nasopharynx, the palatine tonsils at the sides of the oropharynx and the lingual tonsil below, linked by smaller patches of lymphoid tissue.
| Location | Encircles the nasopharynx and oropharynx at the junction of the nasal and oral cavities with the pharynx |
|---|---|
| Secretes |
|
| Lymphatic drainage |
Forms a protective ring of mucosa-associated lymphoid tissue that samples antigens entering through the nose and mouth and triggers immune responses.
Because the ring is the first immune checkpoint for inhaled and swallowed material, it is most active and largest in childhood. It is a common site for extranodal non-Hodgkin lymphoma, which may cause one-sided tonsil enlargement. Asymmetrical tonsil enlargement in an adult should prompt investigation for lymphoma or squamous cell carcinoma.
Non-Hodgkin lymphoma arising in the tonsils or adenoids, often presenting as unilateral tonsil swelling with neck nodes.
Airway narrowing during sleep from enlarged tonsils and adenoids, causing snoring, pauses in breathing and daytime behavioural problems.
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