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Clinical Pathology Case Chalazion Clinical Pathology Case Chalazion

Clinical Pathology Case Chalazion - PowerPoint Presentation

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Clinical Pathology Case Chalazion - PPT Presentation

Angela Elam MD Clinical Course 61 yo woman with a raised vascularappearing upper lid lesion that had been present for a while Increasing in size over time Nontender No madarosis lash loss ID: 913924

www chalazion cell clinical chalazion www clinical cell lipid carcinoma sebaceous papilloma common phs12 35718 eyelid diagnosis molluscum pathology

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Slide1

Clinical Pathology CaseChalazion

Angela Elam, MD

Slide2

Clinical Course

61

yo

woman with a raised, vascular-appearing upper lid lesion that had been present for a while

Increasing in size over time

Non-tender

No (

madarosis

) lash loss

Involving the lid margin

Slide3

Clinical Course

Ophthalmologist’s clinical suspicion was for papilloma

Wedge resection was performed and specimen sent to Pathology for

evaluation

(PHS12-35718)

Slide4

Chalazion

Empty lipid vacuole

Granulomatous inflammation surrounding empty lipid vacuole

PHS12-35718_4

Slide5

Chalazion

Multinucleated giant cells

PHS12-35718_6

Slide6

Chalazion

Generalized

lipogranulomatous

inflammation

Lipid vacuoles

Lipid vacuole

Giant cell

PHS12-35718_2

Slide7

Pathophysiology

Meibomian

glands are a sebaceous glands found in the eyelids

They secrete the oily component of tears

Chalazion

formed when duct supplying a

Meibomian

gland is obstructed

Slide8

Making the Diagnosis

Clinical and pathologic diagnoses correlate more than 90% of the time

When the diagnosis of

chalazion

is missed, sebaceous cell carcinoma is often the correct diagnosis, causing some to believe that all

chalazion

should be sent for pathologic evaluation

Accuracy of the clinical diagnosis of

chalazion

. Ozdal et al. Eye 18; 135-138, 2004

Slide9

Common Treatment Course

Conservative = Warm compresses (many will resolve with conservative therapy)

Medical = Topical antibiotics or subcutaneous steroids

Surgical = Incision and removal

Slide10

Differential Diagnoses

Papilloma

Molluscum

contagiosum

Eyelid Tumors (Examples: sebaceous adenocarcinoma, basal cell carcinoma)

Preseptal

cellulitis

Slide11

Papilloma

www.oculist.net

Sebaceous cell carcinoma

www.sarawakeyecare.com

 

Preseptal

cellulitus

http://

www.funscrape.com

Molluscum

contagiosum

www.EyePlastics.com

Basal cell carcinoma

www.sarawakeyecare.com

 

Chalazion

en.wikipedia.org

 

Slide12

Papilloma

Keratinized epidermal fronds covering

a

fibrovascular

core

Most common benign eyelid lesion; Associated with HPV infection

eyepathologist.com

Slide13

Molluscum Contagiosum

Lobular

acanthosis

, large

basolophilic

poxviral

intracytoplasmic

inclusions composed of poxvirus DNA

www.missionforvisionusa.org

 

Slide14

Sebaceous Adenocarcinoma

Lobules of anaplastic cells with foamy lipid-laden, vacuolated cytoplasm; large

hyperchromic

nuclei; skip areas

Second most common eyelid malignancy; Can be misdiagnosed as a recurrent

chalazion

www.mrcophth.com

Slide15

Basal Cell Carcinoma

Blue

basaloid

tumor cells arranged in nests and cords

Most common malignancy of the eyelid

www.mrcophth.com

 

Slide16

References

Basic Clinical Science

Course: Cornea and External Disease. American

Academy

of Ophthalmology 2009-2010

Eye Pathology: An Atlas and Text, Second edition. Ralph Eagle, 2011

Review of Ophthalmology. Friedman, Kaiser,

Trattler

. 2005