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.

Gross

• Focal eyelid swelling - typically upper eyelid.

DDx (clinical):

• Sebaceous cell carcinoma.
• Basal cell carcinoma.

Images

• 

  Chalazion (WC)

www:

• Chalazion (eyewiki.aao.org).

Microscopic

Features:

• Lipogranulomas - key feature.
  • Granulomatous inflammation around clear spaces (lipid).
  • Multinucleated giant cells - common.
    • +/-Touton giant cells.
• Plasma cells - abundant - important.

DDx:

• Juvenile xanthogranuloma.

Images

• 

  Chalazion. (WC/euthman)

www:

• Chalazion and its clinical DDx (nature.com).
• Chalazion (surgicalpathologyatlas.com).

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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

• Eye.
• Eyelid.