Adenoidal hypertrophy (adults)

Last revised by Rob Foley on 21 Oct 2023

Adenoidal hypertrophy or enlargement in adults is much less commonly seen than in children. It is usually due to chronic infection or inflammation. HIV always needs to be excluded as a cause.


In general, the adenoid tonsils enlarge after birth, maximizing by 6 years old. Thereafter, the adenoids gradually involute and in most individuals can no longer be seen by 16 years old 1.


Causes of adenoidal hypertrophy in adults may include infections, inflammation and allergy:

Radiographic features


Other than increase in size, adenoidal hypertrophy is most commonly associated with hypointensity (low signal) on T1 and hyperintensity (high signal) on T2, in comparison to skeletal muscle 2. Cysts are a relatively common features, seen in 35-65% of patients, increasing in incidence with age 2. Enhancement is present in the majority of patients, usually mild 2.

See also

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Cases and figures

  • Case 1
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