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.
Pathology
In general, the adenoid tonsils enlarge after birth, maximising by 6 years old. Thereafter, the adenoids gradually involute and in most individuals can no longer be seen by 16 years old 1.
Aetiology
Causes of adenoidal hypertrophy in adults may include infections, inflammation and allergy:
allergy
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infections (most common cause)
rhinitis and/or sinusitis
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malignancy
Radiographic features
MRI
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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