Chalazion Coexisting with Dacryolithiasis

A 41-year-old woman presented with a painless hard subcutaneous nodule in the right upper eyelid. The lesion was diagnosed clinically as pilomatricoma and removed surgically. Histological examination disclosed a granulomatous lesion composed mainly of mononuclear cells with a foamy appearance and multinucleated giant cells with some admixture of granulocytes, plasma cells, and lymphoid cells. Lipid droplets and dilated ductal structures containing an eosinophilic fibrillar substance were observed in and around the granulomatous lesion. In addition, an intraductal dacryolith was seen near the granulomatous lesion. We finally diagnosed this case as chalazion; the coexisting dacryolithiasis was considered to be involved in the pathogenesis of chalazion.