Chalazion surgical path results

[ontheone]

I received my pathological report and a diagnosis as far and as the doctor is saying is not a chalazion yet it is a dense dermal chronic inflammatory cell inflilrate.  I'm a little confused because another ophthalmologist diagnosed me with the chalazion I have a hard round bump on my eyelid and the surgeon that I saw has no idea where to go from here he has no idea what this is or what to do next. After the surgery I noted that the incision was not made were the point was, where I felt  the gland should've been. Could it be possible that the gland was not drain properly and a piece of the incision was just the inflammatory tissue near the swollen gland? I'm not sure where to go from here I don't know what to do now I'm still left with a unsightly bump on my eyelid and given no direction by the doctor. Any help will be greatly appreciated.

[JohnHaganMD]

A pathology report has two parts: The description of the tissue and a diagnosis.  the diagnosis you list is consistent with a chalazion. Often the pathologist will say "consistent with a chalazion" but sometimes not. You can ask the surgeon or the pathologist for a more detailed explanation. In any case its not a malignancy and the treatment you've received is appropriate as is the things discussed to prevent another chalazion.

[ontheone]

Thank you for the quick response. My doctor did not tell me any of this. He said he never saw this diagnoses before and it's not a chalazion. I was shocked bc to me what he was referring to was wondering hat sounded like the way the skin is surrounding the chalazion (inflammation).  I didn't say anything to him because to be honest with you I was in shock. He didn't offer me any help he only said he's never seen this diagnosis before and that the only thing to do was to have it surgically removed where they put me under remove it and stitch it back up. I left even more upset than I came in. Personally I think my chalazion wasn't drained only the surrounding tissue was biopsied for some reason. I'm honestly very confused because I thought the day he did it he drained the chalazion, but again he told me nothing that day so I'm not really sure what he did. The bump is bigger now than the original one. I'm so frustrated  I've already scheduled an appointment with another doctor.  
My question now to you is how soon can the area be excised again and drained? My original surgery was three weeks ago.
Thanks again.

[JohnHaganMD]

Well if it were indicated (which it probably isn't) it could be done immediately. If possible be sure you 2nd opinion is an "oculoplastic surgeon" they can be found in most large cities and all medical schools. That path report doesn't seem unusual to me. Be sure you take your 2nd opinion doctor your op report, pathology report and clinic notes.

[ontheone]

The paperwork does not recommend anything other than diagnosis so I don't have an OK to have a second surgery. But it has been three weeks since my first one. The person who did my first surgery is an oculoplastic surgeon.  The doctor that I'm going to now is an ophthalmologist who was recommended to me by a friend who had a chalazion removal from him successfully. I'm going to bring all my reports with me. Thank you again.  

[JohnHaganMD]

you have a right to ask for a copy of the complete pathology report not just the "Impression"

[ontheone]

What I have is a surgical pathology consultation report there's a diagnosis on there it says clinical diagnosis, history, specimens source, gross description and microscopic description but there's no recommendation. He's telling me it's not a chalazion.  He wanted to put me under actually cut it out and so it back together. I'm uneasy with that St this time.  He also mentioned maybe using a steroid injection to see if that would shrink it. But he seem like he was on sure really what to do. And this is an oculoplastic surgeon. That's why I just don't know what to do other than get a second opinion because I truly believe it a chalazion that he didn't drain or didn't drain properly.  After the surgery I feel like for five days it look like it was going down on the fifth day it started to swell again and now it's bigger than it was before.
Do you think if anything and injection could shrink it? Thank you again for your time and help.

[JohnHaganMD]

This is about all I can tell you: 1. Looks like you have the entire path report. They do not make recommendations on treatment. 2. A second opinion is your best bet at this time.

[ontheone]

Great. Thank you. I appreciate your help.  

[JohnHaganMD]

Good luck