Background: Cytologically, a chalazion may be either a mixed-cell or a suppurating granuloma. Treatment includes incision & curettage or intralesional steroid injection. The choice of treatment is based on clinical experience.
Objective: To determine whether the cytological type of chalazion has any bearing on its response to treatment.
Materials and methods: Prospective study of 62 clinically suspected cases of chalazia subjected to fine-needle aspiration cytology followed by either incision & curettage or intralesional steroid injection. The outcome measure was the size of the residual lesion at one week and one month post-intervention. The relationship between cytology and age, duration, size of lesion, type of treatment and response was analyzed by means of Student's t-test, the chi-square test and discriminant analysis.
Results: Thirty-five (56.5%) patients underwent incision & curettage while 27 (43.5%) received intralesional steroid injections. Cytology revealed mixed-cell granuloma in 41 (66.1%) and suppurating granuloma in 21 (33.9%) of the lesions. Patients aged > or = 35.1 years, lesions with duration > or = 8.5 months, and lesion sizes > or = 11.4 mm (correctly classified in 66.1%, 66.7% and 71.0% of the cases, respectively) were likely to have/be suppurating granulomas. Mixed-cell granulomas responded equally well to the two therapeutic modalities, while suppurating granulomas responded significantly better to incision & curettage (p = 0.008).
Conclusion: Mixed-cell granulomas may be treated by either of the two therapeutic modalities. However, suppurating granulomas should be treated by incision & curettage. Incision & curettage should also be the procedure of choice in patients > or = 35.1 years of age, lesions with duration > or = 8.5 months, and lesions > or = 11.4 mm in size.