White granules on top of palatine tonsils are commonly seen in acute follicular tonsillitis, tonsil stones, chronic crypt tonsillitis and other types of lesions. 1. Acute follicular tonsillitis: this type of tonsillitis is caused by irritation of the tonsils due to measles and other diseases, malnutrition and other reasons, which leads to white particles on the top of the palatine tonsils, difficulty in swallowing and other symptoms. 2. Tonsil stones: The blockage of the crypt orifices by food debris, bacteria, etc., which causes caseous mineral salt clusters, commonly known as tonsil stones, leads to bad breath and the above mentioned features. 3. Chronic crypt tonsillitis: a large number of shed epithelial cells, lymphocytes, leukocytes and bacteria gather in the glandular crypts to form pus plugs, or the crypt mouth can’t be discharged due to inflammation scar adhesion, forming pus plugs or cysts, which become foci of infection. This may be manifested as white granules on the palatine tonsils. Patients who find white particles on palatine tonsils should actively seek medical treatment, and only after systematic examination can a clear diagnosis be made.