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Difference between revisions of "Chalazion"
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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]] | ||