The occurrence of the “so-called actinomycotic granules” in the human tonsilar crypts has long been one of the disputable point for the etiology of actinomycosis. However, a few histopathological studies on the “so-called actinomycotic granules” in the tonsilar crypts have been reported, so far. The author, therefore, examined the tonsils of 137 necropsy cases, which consisted of 90 cases of University of Showa and 47 cases from the Tokyo Metropolitan Medical Examiner's Office. Extensive histopathological investigations were carried out and age and sex incidences were examined. Morphological scurnity on constitutional elements of the “granules” was also performed. Tonsils of 48 autopsy cases. were submitted for cultural studies. The results obtained will be presented here.
1. The incidence of the “granules” in the tonsilar crypts among the 137 cases was 59.9% (82 cases).
2. Sex incidence was 61.6% in male and 57.4% in female. High incidence of the “granules” was noticed in the middle age groups, and no “granules” was found in new born and still born babies.
3. In 38 cases (46.4%) the “granules” were disclosed in bilateral tonsils. In 44 cases the “granules” were found in unilateral tonsils, however, both right and left tonsils indicated the same incidence (26.8%, in both) in this group.
4. The “granules” were observed in higher incidence in summer and autumn than in winter and spring. This seasonal difference could be assumed identical to the seasonal difference of the pharyngolaryngeal and pulmonary fungal flora, which have been reported elswhere.
5. The author classified the tonsils into three types macroscopically, e. g., a) protrude type, b) flat type and c) caved type. Among the age groups of more than 40 years, the occurrence rates of the “granules” were 75.0% in the protrude type, 70.3% in the flat type, and 53.5% in the caved type.
6. The incidence of the “granules” was 49.4% (42/85) in the cases of the University of Showa, and 76.9% (40/52) in the Medical Examiner's cases. The author considered that the cause of death, the state of development of tonsils and influences from therapeutic agents might be contributing factors for the difference.
7. By the morphological characteristics of constitutional elements of the “granules”, the author determined the microorganisms of the “granules” as follows; Actinomyces, Nocardia, Candida, filamentous fungi, bacteria and undetermined. It was disclosed that constitutional elements of the “granules” were composed usually of more than two kinds of microorganisms, and the “granules” which composed of a single microorganism were rather rare. Actinomyces was found most frequently, the incidence was 76.7% (63 in 82 cases). The other microorganisms were disclosed as follows; Nocardia 1 case, Candida 17 cases, filamentous fungi 19 cases, bacteria 5 cases, and undetermined 8 cases.
8. Candida was found in the tonsilar crypts more frequently than expected. In only one case, Candida with pseudohyphal pattern invaded into tonsilar tissue, however, in most of the cases saprophytic Candida was observed as spores in tonsilar crypts, and neither hyphal growth nor tissue invasion were demonstrated.
9. Fluorescent antibody technic (Uetsuka) was applied in order to examine the reliability of histopathological-etiological diagnosis of the “granules”, and it was confirmed that histopathological diagnosis was considerably reliable.
10. Cultural examinations of filamentous fungi and yeasts were performed in 48 cases, using peptone glucose Chloramphenicol agar media.

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