Pathology · patient case question
What is this white concretion in the oropharynx?
Patient case: Young man with a white 'stone' in his throat
Patient: Male, 21 years old
Chief complaint: “I have this white stone in my mouth that doesn't want to come out.”
Background: Had influenza 3 weeks ago. Oral hygiene is normal.
Current findings: White, calculus-like concretion visible in the oropharynx.
Show answer and explanation
Correct answer: B. A tonsillolith (tonsil stone)
- A. A sialolith forms within a salivary duct, most often Wharton duct of the submandibular gland, and causes mealtime swelling and pain — not a visible oropharyngeal stone.
- B. CORRECT. TONSILLOLITHS form when food debris, desquamated cells and bacteria become trapped and calcify within the tonsillar crypts. They follow episodes of tonsillitis, present as white or yellowish concretions, and characteristically cause halitosis and a foreign-body sensation.
- C. A peritonsillar abscess is an acutely painful, fluctuant swelling displacing the tonsil and uvula, with trismus and a muffled voice — a very different clinical picture.
- D. A parulis is the soft tissue swelling at the opening of a sinus tract from an odontogenic abscess, on the alveolar mucosa.