1/18. Juvenile xanthogranuloma of the orbit in an adult.We present a case of juvenile xanthogranuloma (JXG) with unilateral involvement of the orbit and eyelid and proptosis, histologically confirmed in a 32-year-old man with a 1-year history of a pansinusitis and dacryoadenitis with rhinitis. Nine months later an infiltration of the anterior upper part of the right orbit and right eyelid appeared. Computed tomography scan and magnetic resonance imaging studies confirmed the presence of pansinusitis and infiltration. The patient underwent a blepharoplasty and excision of the infiltrated tissues of the orbit, eyelid, and levator muscle. hematoxylin-eosin and immunohistochemical studies revealed features consistent with a diagnosis of JXG (Touton giant cells). JXG, a non-Langerhans'-type benign proliferation, is a rare condition in adulthood.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/18. Upper eyelid mycobacterial infection following Oriental blepharoplasty in a pulmonary tuberculosis patient.Bilateral upper blepharoplasty for the Oriental eyelid was performed in a 20-year-old female on antituberculous therapy for 3 months. The postoperative course was smooth and the patient was back to normal life. But unfortunately, at 3 months after the upper blepharoplasty, a spherical tumescence and red granuloma developed over the right upper eyelid. The granuloma was resected, and on pathological examination the specimen revealed epitheloid granuloma with Langhan's giant cells and a few acid-fast positive bacilli. The clinical events and pathological findings were suggestive of mycobacterium tuberculosis rather than Mycobacterium chelonei as the possible cause of infection. Thus the patient was advised to continue antituberculous therapy and no antibiotic was prescribed. The eyelid swelling resolved gradually and was completely normal at the end of antituberculous therapy. Though it has been suggested that aesthetic surgery can be performed safely 3 months after antituberculous therapy in a patient with pulmonary tuberculosis, the remote risk of such a complication is always a possibility.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/18. Solitary spindle-cell xanthogranuloma of the eyelid.PURPOSE: To describe a rare presentation of a solitary spindle-cell xanthogranuloma in a 3-year-old boy with a 6-month history of a right upper lid soft tissue lesion. DESIGN: Interventional case report. methods: An excisional full-thickness biopsy of the right upper lid was performed. Histologic examination and immunohistochemistry of the specimen were performed. RESULTS: Histopathologic evaluation revealed a well-demarcated nodule arising from the tarsus that contained a storiform array of spindle cells admixed with numerous multinucleated giant cells (some Touton type) and lymphocytes. The spindle cells labeled with antibodies to factor xiiia, CD68, lysozyme, Mac 387, and vimentin. The multinucleate giant cells labeled with CD68, lysozyme, and vimentin. Findings were consistent with the diagnosis of solitary spindle-cell xanthogranuloma. CONCLUSIONS: Spindle-cell xanthogranuloma resembles juvenile xanthogranuloma and fibrous histiocytoma (dermatofibroma) and should be considered in the differential diagnosis of spindle-cell tumors of the eyelid and periocular region. If similar lesions are noted elsewhere, the diagnosis of progressive nodular histiocytoma should be considered.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
4/18. adult orbital xanthogranuloma with associated adult-onset asthma.: The authors report a case of adult orbital xanthogranuloma with associated adult-onset asthma in a 44-year-old man. adult orbital xanthogranuloma was diagnosed on the basis of the clinical findings of bilateral, indurated, yellow eyelid lesions in a patient presenting with adult-onset asthma. Incisional biopsy of the eyelid lesions demonstrated a diffuse histiocytic infiltrate of the orbit and Touton giant cells without evidence of necrobiosis. Systemic evaluation failed to show evidence of bone lesions or paraproteinemia. When patients present with atypical indurated yellow eyelid lesions, a biopsy should be considered. If Touton giant cells are present, a systemic evaluation should be undertaken to rule out both erdheim-chester disease and necrobiotic xanthogranuloma. If no systemic findings are present, other than the possibility of adult-onset asthma, the rare entity of adult orbital xanthogranuloma should be considered.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
5/18. Juvenile xanthogranuloma presenting with unilateral prominent nodule of the eyelid: report of a case and clinicopathological findings.BACKGROUND: The purpose of this study is to report and describe the clinical and histopathologic findings in a patient with juvenile xanthogranuloma presenting as a relatively large, solitary, pedunculated mass on the left upper eyelid. CASE: A 31-month-old Japanese girl presented with a pedunculated nodular lesion that had been developing since 4 months earlier. Otherwise, no abnormal findings were identified in either eye. In addition, no other abnormalities, including skin eruptions or nodules, were detected anywhere. The lesion was completely excised and examined histopathologically. OBSERVATIONS: Microscopic study revealed a histiocytic proliferation accompanied by lymphocytes and occasional plasma cells and eosinophils within the dermis. A moderate number of giant cells of the foreign-body and Touton types were present. In the immunohistochemical analysis, the proliferative histiocytes and giant cells showed positive immunoreactivity for vimentin and macrophage markers and negativity for S-100 protein. The diagnosis of juvenile xanthogranuloma was made. The findings of further detailed ophthalmologic and systemic examinations and evaluations were unremarkable. Therefore, the diagnosis was made of juvenile xanthogranuloma, solitary type, occurring on the eyelid. CONCLUSIONS: Although juvenile xanthogranuloma of the eyelid is uncommon and its occurrence anywhere in the eye is rare, ophthalmologists should be familiar with this entity. Juvenile xanthogranuloma should be included in the differential diagnosis of eyelid mass lesions.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
6/18. Eyelid lipogranuloma after hydraulic oil injury.The cytopathology of a lipogranuloma of external origin is reported in the eyelid of a 32-year-old man excised 1 year following regional exposure to an explosion of hydraulic oil under high pressure. The foreign lipids were still present in chronic lipogranulomas with intercellular lipid-filled cysts surrounded by macrophages and giant cells containing intracellular lipid-filled vacuoles. These indicate efforts in storage and very slow digestion. Secondary fibrosis in the region of the lipogranuloma was an important associated process. In view of the widespread technical use of hydraulic oily fluids under high pressure, it is recommended that these fluids be biodegradable.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/18. Fibrous histiocytoma of the tarsus.A 21-year-old white man had an asymptomatic eyelid mass that had slowly enlarged for one year. On clinical examination the lesion was well circumscribed; it appeared subconjunctivally but provoked no conjunctival inflammation, and had a consistency suggestive of cartilage. Microscopic examination showed it was matted and composed of elongated fibro-histiocytes and an evenly distributed population of xanthoma cells and Touton giant cells. The lesion was easily removed by local excision because of a pseudocapsule formed by remnants of the tarsus; there has been no recurrence during a 12-month follow-up.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/18. Orbital and eyelid involvement with erdheim-chester disease. A report of two cases.erdheim-chester disease is an idiopathic condition characterized by infiltration of the heart, lungs, retroperitoneum, bones, and other tissues by a fibrosing xanthogranulomatous process composed of xanthomatous histiocytes and Touton giant cells. This condition is often fatal, with death due to cardiomyopathy, severe lung disease, or chronic renal failure. Ocular findings with this potentially fatal disease are rare. We report the clinical and histopathologic findings in two cases of bilateral xanthelasmas and bilateral orbital infiltrates in association with erdheim-chester disease. The first patient was a 38-year-old man with cardiovascular and renal disease and severe retroperitoneal fibrosis. The massive orbital infiltration produced bilateral blindness. The second patient was a 77-year-old man with severe cardiovascular disease and retroperitoneal fibrosis. The diagnosis was confirmed in both patients with retroperitoneal and orbital biopsies. Both patients had the unusual occurrence of bilateral xanthelasmas with bilateral, diffuse orbital masses, eye findings that should alert the clinician to the possibility of this serious systemic disease.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/18. Subepidermal calcified nodules of the eyelid.Two children had subepidermal calcified nodules of the upper eyelid. The first patient was a 13-year-old girl who noted painless increase in size of a lesion involving her right upper eyelid over four months. The clinical diagnosis was "warty papilloma." The second patient was a 13-year-old boy who had a slowly growing, keratinized lesion involving his left upper eyelid. The clinical diagnosis was "cutaneous horn." On histopathologic examination, the nodules demonstrated the characteristic changes associated with subepidermal calcified nodules, including the presence of calcified material in the uppermost dermis, occasional foreign body giant cells around the calcific masses, acanthosis of the overlying epithelium, and calcium granules in the epidermis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
10/18. Allergic granulomatous nodules of the eyelid and conjunctiva. The XXXV Edward Jackson Memorial Lecture.We studied the clinical and pathologic features of 22 cases of granulomas of the conjunctiva or eyelids. All cases showed the histologic features of the Splendore-Hoeppli phenomenon, that is, a giant cell and eosinophil granulomatous reaction to an antigen-antibody precipitate originally described in relation to parasites or fungi. In four of seven typical cases selected for detailed description unidentified nematodes were found to be the cause of the condition. In light of these findings together with a review of similar "allergic granulomas" reported both in ocular tissues and elsewhere in the body, we considered the cause in the remaining cases. All 22 cases may have been caused by nematodes, as seems, probable in 14 of them, or the causative antigens may have been of widely different kinds. Although in our cases all ocular granulomas had an identical histology, this study did not resolve the problem of those cases where no causative agent was found. Thorough investigation of such cases in the future and the demonstration of their cause may elucidate the wider problem of nonocular allergic granulomas.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
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