Chronic Granulomatous Inflammation of the Eye lids

ABSTRACT

Granulomatous inflammation is characterized by granuloma formation with a cellular infiltrate of epithelioid cells, giant cells, and chronic inflam-matory cells.It could be diagnosed as a subtype of inflammatory pseudotumor when such identifiable causes of granulomatous inflammation have been ruled out. We performed excisional biopsy on 3 patients who complained of upper eyelid mass.The levator muscle was mainly affected in two patients and the lacrimal gland in one patient. Microscopic examination of the mass demonstrated chronic granulomatous inflammation including non-caseating necrosis, diffuse chronic inflammatory cell infiltrates, and granuloma com-posed of histiocytes, multinucleated giant cells, lymphocytes, and epithelioid cells in all 3 patients.There was no evidence of foreign material and infec-tion with tuberculosis, mycosis, and parasites.The diagnosis of sarcoidosis, connective tissue disease, and Wegener's granulomatosis could be ruled out through the basic hematological test, chest radiograph, and blood tests such as angiotensin converting enzyme, lysozyme, antinuclear antigen, and anti-neutrophil cytoplasmic antibody. We experienced 3 cases of chronic granulomatous inflammation of the eyelids without identifiable causes which responds to excision and postoperative steroid therapy without recurrences.