The mucosal surface within the pharynx has a large number of scattered lymphoid follicles that present as a dark red granular appearance. On examination of the pharynx, the mucous membrane of the posterior pharyngeal wall is seen to be congested, and the lymphoid follicles in the lateral pharyngeal cord and tongue root are hyperplastic, swollen and, in severe cases, arranged in a granular pattern. If there is lymphatic fluid that cannot be removed in time, yellowish-white dots or even partial exudate may be seen on the granules.