Difference between revisions of "Chalazion"

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#redirect [[Eye#Chalazion]]
The '''chalazion''' is a common benign pathology of the [[eyelid]].


==General==
*Benign eye thingy that arises from the special sebaceous gland associated with the eyelid (Meibomian gland).
*Usually diagnosed based on clinical appearance - accuracy ~94% in one series.<ref name=pmid14762403>{{Cite journal  | last1 = Ozdal | first1 = PC. | last2 = Codère | first2 = F. | last3 = Callejo | first3 = S. | last4 = Caissie | first4 = AL. | last5 = Burnier | first5 = MN. | title = Accuracy of the clinical diagnosis of chalazion. | journal = Eye (Lond) | volume = 18 | issue = 2 | pages = 135-8 | month = Feb | year = 2004 | doi = 10.1038/sj.eye.6700603 | PMID = 14762403 | url = http://www.nature.com/eye/journal/v18/n2/full/6700603a.html }}</ref>
==Gross==
*Focal eyelid swelling - typically upper eyelid.
DDx (clinical):<ref name=pmid14762403/>
*[[Sebaceous cell carcinoma]].
*[[Basal cell carcinoma]].
===Images===
<gallery>
Image:Gradowka.jpg | Chalazion (WC)
</gallery>
www:
*[http://eyewiki.aao.org/File:Chalazion2_01242005.jpg Chalazion (eyewiki.aao.org)].
==Microscopic==
Features:
*Lipogranulomas - '''key feature'''.<ref name=pmid14762403/>
**[[Granuloma]]tous inflammation around clear spaces (lipid).<ref name=pmid15029054>{{Cite journal  | last1 = D'hermies | first1 = F. | last2 = Fayet | first2 = B. | last3 = Meyer | first3 = A. | last4 = Morel | first4 = X. | last5 = Halhal | first5 = M. | last6 = Elmaleh | first6 = C. | last7 = Azan | first7 = F. | last8 = Behar-Cohen | first8 = F. | last9 = Renard | first9 = G. | title = [Chalazion mimicking an eyelid tumor]. | journal = J Fr Ophtalmol | volume = 27 | issue = 2 | pages = 202-5 | month = Feb | year = 2004 | doi =  | PMID = 15029054 }}</ref>
**Multinucleated giant cells - common.
***+/-[[Touton giant cell]]s.<ref>URL: [http://emedicine.medscape.com/article/1212709-workup http://emedicine.medscape.com/article/1212709-workup]. Accessed on: 9 February 2012.</ref>
*Plasma cells - abundant - '''important'''.
DDx:<ref>{{Ref DCHH|194}}</ref>
*[[Juvenile xanthogranuloma]].
===Images===
<gallery>
Image:Chalazion_of_the_Eyelid.jpg | Chalazion. (WC/euthman)
</gallery>
www:
*[http://www.nature.com/eye/journal/v18/n2/fig_tab/6700603f1.html#figure-title Chalazion and its clinical DDx (nature.com)].<ref name=pmid14762403/>
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?f=0&sort=0&s=20080802170139555 Chalazion (surgicalpathologyatlas.com)].
==Sign out==
<pre>
EYELID LESION, RIGHT UPPER, BIOPSY:
- LIPOGRANULOMAS.
- LYMPHOPLASMACYTIC RICH INFLAMMATORY INFILTRATE.
- GRANULATION TISSUE.
- REACTIVE SQUAMOUS MUCOSA.
COMMENT:
The findings are consistent with a chalazion.
Special stains (ZN, PASD, GMS) did not demonstrate microorganisms.
</pre>
===Alternate===
<pre>
SKIN LESION, LEFT LOWER EYELID, PUNCH BIOPSY:
- LIPOGRANULOMAS WITH GIANT CELLS AND A LYMPHOPLASMACYTIC RICH INFLAMMATORY
  INFILTRATE -- CONSISTENT WITH CHALAZION.
- GRANULATION TISSUE.
- NEGATIVE FOR MALIGNANCY.
</pre>
===Micro===
The sections show a reactive squamous mucosa with palisading granulomas that surround clear spaces (lipid). This is accompanied by a lymphoplasmacytic rich inflammatory infiltrate. Granulation tissue is present. Rare multinucleated giant cells are identified. Neutrophils are numerous and seen in association with the histiocytes.
No significant nuclear atypia is apparent.
==See also==
*[[Eye]].
==References==
{{Reflist|1}}
[[Category:Eye]]
[[Category:Diagnosis]]
[[Category:Diagnosis]]

Revision as of 13:56, 1 October 2015

The chalazion is a common benign pathology of the eyelid.

General

  • Benign eye thingy that arises from the special sebaceous gland associated with the eyelid (Meibomian gland).
  • Usually diagnosed based on clinical appearance - accuracy ~94% in one series.[1]

Gross

  • Focal eyelid swelling - typically upper eyelid.

DDx (clinical):[1]

Images

www:

Microscopic

Features:

DDx:[4]

Images

www:

Sign out

EYELID LESION, RIGHT UPPER, BIOPSY:
- LIPOGRANULOMAS.
- LYMPHOPLASMACYTIC RICH INFLAMMATORY INFILTRATE.
- GRANULATION TISSUE.
- REACTIVE SQUAMOUS MUCOSA.

COMMENT:
The findings are consistent with a chalazion.

Special stains (ZN, PASD, GMS) did not demonstrate microorganisms.

Alternate

SKIN LESION, LEFT LOWER EYELID, PUNCH BIOPSY:
- LIPOGRANULOMAS WITH GIANT CELLS AND A LYMPHOPLASMACYTIC RICH INFLAMMATORY
  INFILTRATE -- CONSISTENT WITH CHALAZION.
- GRANULATION TISSUE.
- NEGATIVE FOR MALIGNANCY.

Micro

The sections show a reactive squamous mucosa with palisading granulomas that surround clear spaces (lipid). This is accompanied by a lymphoplasmacytic rich inflammatory infiltrate. Granulation tissue is present. Rare multinucleated giant cells are identified. Neutrophils are numerous and seen in association with the histiocytes.

No significant nuclear atypia is apparent.

See also

References

  1. 1.0 1.1 1.2 1.3 Ozdal, PC.; Codère, F.; Callejo, S.; Caissie, AL.; Burnier, MN. (Feb 2004). "Accuracy of the clinical diagnosis of chalazion.". Eye (Lond) 18 (2): 135-8. doi:10.1038/sj.eye.6700603. PMID 14762403. http://www.nature.com/eye/journal/v18/n2/full/6700603a.html.
  2. D'hermies, F.; Fayet, B.; Meyer, A.; Morel, X.; Halhal, M.; Elmaleh, C.; Azan, F.; Behar-Cohen, F. et al. (Feb 2004). "[Chalazion mimicking an eyelid tumor].". J Fr Ophtalmol 27 (2): 202-5. PMID 15029054.
  3. URL: http://emedicine.medscape.com/article/1212709-workup. Accessed on: 9 February 2012.
  4. Tadrous, Paul.J. Diagnostic Criteria Handbook in Histopathology: A Surgical Pathology Vade Mecum (1st ed.). Wiley. pp. 194. ISBN 978-0470519035.