Purchase this article with an account.
Hiroaki Ito, Sabrina Bergeron, Christina Mastromonaco, Milena Almeida, Evangelina Esposito, Miguel N Burnier; Demographical distribution of chalazia according to their histopathological subtypes: A series of 1357 cases.. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5218.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Chalazia is a common inflammatory condition that is diagnosed by granulomas surrounding lipid droplets (lipogranulomas) due to the blockage of a secretory duct of the eyelid. If left untreated, persistent chalazion causes discomfort and may lead to complications.It is well known that neoplasia such as sebaceous carcinoma can mimic the clinical picture of a chalazion, a phenomenon described as the masquerade syndrome. Therefore, it is imperative to send excised chalazion for histopathological diagnosis.Our aim is to verify whether pre-determined histopathological features of chalazion are associated to a specific patient demographic in order to formulate recommendations for lesions that are priority for histopathological evaluation.
A total of 1357 biopsy proven chalazions were included (619 F, 738 M). The mean age of the patients was 46 years (st. dev 17.62) and 58% (n =790) were on the upper eyelid. Histopathological review was conducted and each lesion was assigned to one of four categories: 1) lipogranulomas only, 2) lipogranulomas with multi-nucleated giant cells, 3) lipogranulomas with abscesses formation and 4) fibrosis and granulation tissue. A chi-squared test was performed to assess correlations between histopathology and patient’s gender, age group and location of the lesion.
Of the 1357 lesions, 651 belonged to the first category (48%) and 570 to the second (42%). The 3rd and 4th category represented 54 and 81 cases (4% and 6%), respectively. Chi-squared test revealed no significant correlation between histopathological classification and the patients’ gender or age group (0-45 and over 45 years old). Moreover, there is no statistical relation between the presence of giant cells and/or abscesses and the location of the lesion. Of the lesions analyzed, two were proven to be sebaceous carcinoma. Both were located on the upper eyelid.
The three main subtypes of chalazion are equally distributed across all genders, age group and eyelid location. Despite variable histopathological patterns, all chalazia are clinically equivalent, supporting the need for histopathological diagnosis to rule out any sign of malignancy. Sebaceous carcinoma was diagnosed in two patients of the fourth category of chalazion. The absence of lipogranulomas should raise a suspicion that this lesion is not a true chalazion.
This is a 2020 ARVO Annual Meeting abstract.
This PDF is available to Subscribers Only