• Archives of Plastic Surgery
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• v.35 no.5
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• pp.603-606
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• 2008

Purpose: Sclerosing lipogranuloma is an unusal benign condition of the genitalia following injections into the genitalia with exogenous paraffin or mineral oil. A few cases have been reported in which sclerosing lipogranuloma of the lid was caused by paraffin-containing ointment plugs after the endonasal sinus surgery. A 52-year-old man presented with a painless hard mass of the right lower lid after the MRI scan at the Ophthalmology department. Nine months before, he had undergone right maxilla sinus surgery through the oral incision. And he was also gotten nasal packing with Vaseline gauze after the surgery. Methods: The round shaped two masses in the Right lower lid were approximately $1.0{\times}1.0cm$ in size. There were no size or color change, bleeding and ulceration. The MRI scan showed a suspicious part of an abscess of benign tumor. Also, He was planned cyst remove through the endonasal surgery due to the mucoid cyst in the right maxillary sinus in the ENT dept. Under the general anesthesia, the patient underwent surgical excision through a subcilliary incision with endonasal sinus surgery. The masses were in deep subcutaneous orbital fat with no connection with right maxillary sinus. Results: The masses were excised $2.1{\times}0.7cm$ in size including surrounding necrotic fatty tissue. Histopathological diagnosis was 'sclerosing lipogranuloma' due to paraffin or similar substance with fat necrosis and cystic change. This tissue was positive in PAS, S-100, CD68 reaction. Conclusion: It is extremely rare to find a granulomatous orbital lesion arising to a endonasal surgery. In conclusion, if sclerosing lipogranuloma is suspected excisional biopsy should be undertaken. Surgery should be reserved for recurrent or refractory cases when steroids have failed as first-line treatment at the 6-month follow-up examination, There was no complication or recurrence.

• Archives of Craniofacial Surgery
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• v.19 no.3
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• pp.227-230
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• 2018

"Paraffinoma" is a well-recognized complication of paraffin oil injection into various body parts for an aesthetic purpose. After a variable latency phase, paraffinoma can present as a wide range of clinical symptoms. This paper is a case report of surgical excision of the paraffinoma and subsequent reconstruction of the associated skin defect on bilateral preauricular cheeks, manifesting 50 years after a primary injection.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7513-7516
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• 2015

Background: Pyogenic granuloma is a common non-neoplastic connective tissue proliferation. ICAM-1 and VCAM-1 are vascular adhesion molecules and CD34 is a marker for evaluation of angiogenesis. The purpose of this study was to compare the immunohistochemical expression of ICAM-1, VCAM-1 & CD34 in oral pyogenic granuloma and normal gingiva. Materials and Methods: This study was performed on thirty five formalin-fixed, paraffin embedded samples of gingival pyogenic granuloma. Also we used thirty five paraffined blocks of normal gingiva as control group which were taken from crown lengthening surgery. We employed immunohistochemistry staining for our prepared microscopic slides using monoclonal mouse anti-human antibodies against ICAM-1 (CD54), VCAM-1 (CD106) and CD34. Slides were examined under light microscope and then the mean amount of stained vessels also known as microvascular density (MVD) in highly vascularized areas (hot spots) was measured. Paired t-test and repeated measures ANOVA were used to compare the difference between quantitative variables and Chi-square test for qualitative variables in different groups. Pearson correlation coefficient was used to compare relations between quantitative variables. P<0.05 was considered significant. Results: The mean of MVD for ICAM-1, VCAM-1 and CD34 was significantly higher in pyogenic granuloma than normal gingiva (p<0.001 & p<0.001 & p<0.001, respectively). Expression of CD34 in pyogenic granuloma was significantly higher than ICAM-1 and VCAM-1 (P<0.001). Besides, expression of ICAM-1 in normal gingiva, was significantly lower than two other markers (p<0.001). Conclusions: Regarding the results, it seems that ICAM-1, VCAM-1 and CD34 are useful biomarkers in evaluation of vascular and inflammatory lesions such as gingival pyogenic granuloma and the results indicate the role of these biomarkers in pathogenesis of oral pyogenic granuloma.

• Korean Journal of Veterinary Service
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• v.26 no.1
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• pp.67-71
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• 2003

A 8 months old, female domestic Shorthair cat with long-term signalment of anorexia, lacrimation, uveitis and coughing was submitted to the Pathology and Diagnosis Reference Division, NVRQS, Korea, for necropsy. Main gross lesions were characterized by ascities, some grayish-white nodular formation and fibrous adhesion on the surface of visceral organs including liver and kidney. Principle histopathological findings were fibrinous serositis, multifocal granuloma and necrosis, vasculitis, perivasculitis in various pharenchymal organs. Paraffin-embedded tissue sections taken from most of organs with granulomatous lesions were confirmed specific reaction to the monoclonal antibody of feline infectious peritonitis virus in the cytoplasm of many infiltrating macrophages by immunohistochemistry. The report was to describe the pathological lesions of the first naturally-occuring FIP case in companion cat of Korea.

• Archives of Plastic Surgery
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• v.37 no.3
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• pp.233-238
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• 2010

Purpose: As the use of soft tissue fillers becomes more popular, complications such as foreign body granuloma (FBG) are increasing. We report 120 cases of facial FBG and review the available literatures. Methods: 120 patients of facial FBG in our clinic from Mar. 2003 to Feb. 2008 were complied and analyzed. A retrospective chart review was done and patient satisfaction was evaluated with a questionnaire using 5 score scale. Patients with severe inflammation sign or bizarre deformity underwent surgical excision and those with minimal symptoms or a history of hyaluronic acid injection received injection therapy using hyaluronidase. Results: 100 females and 20 males were observed. The average age was 43.7 years (from 16 to 74). 84 patients received surgical therapy and 36, injection therapy. Deformity of facial contour, foreign body sensation and inflammation sign were the three main chief complaints. 84 patients did not know what the injection materials were. The known materials are as follows: collagen, hyaluronic acid, silicone oil, paraffin. 92 cases were performed by unlicensed practitioners, 29 by physicians. Anatomical site most frequently affected by the foreign body granuloma was the cheek (25.8%), followed by forehead (19.2%), lips (15.8%), nose (9.2%), mentum (8.3%), eyelid and eyebrow (4.3%) and temple (0.8%). In 21 patients (17.5%), FBGs were found on multiple sites. Patients with inflammation sign got the highest satisfaction ($3.19{\pm}0.73$) (p=0.001) among 3 chief complaints. And patient satisfaction was statistically higher in surgical therapy group ($3.43{\pm}0.72$) than in injection therapy group ($2.97{\pm}0.88$) (p=0.003). Conclusion: We suggest that it may be beneficial to tailor the type of treatment for FBG relying on wound state and patient's chief complaints. In surgical therapy, resolute approach is necessary to correct facial deformity definitely and to minimize inflammation. Injection therapy could be another option for those with minimal symptoms or a history of hyaluronic acid injection. To prevent foreign body granuloma, not only plastic surgeons but also other physicians should inject soft tissue fillers with great caution and we should warn the public of disastrous consequences associated with illegal medical practice.

• Archives of Plastic Surgery
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• v.38 no.4
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• pp.391-397
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• 2011

Purpose: The injection of various materials, including medical fillers and unregulated products, is widespread, potentially causing the development of foreign body granulomas. Should this occur on the nose, the contour deformity and inflammatory signs that result from these granulomas are aesthetically undesirable to patients. The purpose of our study is to share our experiences using different surgical approaches, depending on the affected portion of the nose, to optimize management of this challenging problem and to evaluate patient's satisfaction using our in-house questionnaire along with degree of improvement by two independent plastic surgeons. Methods: We treated 18 patients who underwent surgical excision of nasal foreign body granulomas via a perilesional approach to the lesion (n=12) or by transcolumellar incision (n=6) at our hospital over a period of seven years from March 2003 to October 2010. Nonparametric statistics were used and are presented as medians (25th-75th). Patient satisfaction was evaluated on a scale of 1 to 5 using an in-house questionnaire. All pre-and post-operative photographs were analyzed by two independent plastic surgeons. Post-operative outcomes were evaluated based on the surgeons' consensus ratings. Results: All patients receiving the transcolumellar approach reported a high level of satisfaction with the results. All but two patients who received the perilesional approach were satisfied with the outcome. No outcomes were rated as no change or worse by the consensus ratings. Conclusion: For the upper two-thirds of the nose, perilesional surgical excision can lead to substantial patient satisfaction with modified contour deformity and infection control. The transcolumellar approach resulted in better outcomes and patient satisfaction for the lower one-third of the nose.

• Restorative Dentistry and Endodontics
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• v.18 no.2
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• pp.317-340
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• 1993

This study was designed 1) to compare the distributions of periapical inflammatory cells and 2) to identify lymphocytes and compare the lymphocyte distribution with T lymphocyte subpopulation and then 3) to examine the distribution of cycling cell in human dental periapical lesions. From each of the twenty-five human dental periapical lesions observed one small portion was fixed, embeded in paraffin, sectioned serially and stained with HE. The periapical inflammatory cells were counted to obtain the relative concentration of lymphocyte, plasma cell, macrophage and neutrophil. The large part of each lesion was analysed using Flow cytometer and monoclonal antibodies to obtain the relative concentration of T lymphocyte, B lymphocyte, T'helper cell and T suppressor/cytotoxic cell. In addition to that, seven human dental periapical lesions were examined with DNA analysis to observe the distribution of cycling cell. Following results were obtained: 1. 24 cases of the 32 periapical lesions examined were diagnosed as periapical granuloma and the remaining 8 cases as periapical cyst. Lymphocytes comprised 42.1% of total inflammatory cells in periapical granuloma and 41.8% in periapical cyst. Corresponding percentages for macrophages were 33.8% and 30.3%; for plasma cells, 15.9% and 19.0%; for neutrophils, 8.2% and 8.8%. 2. All of the periapical lesions examined had T lymphocyte, B lymphocyte, T helper cell, T suppressor/cytotoxic cell. And in all cases, T lymphocytes were observed predominantly more than B lymphocytes. 3. In 2 cases of the control group only T lymphocytes were found, and in the remaining 2 cases T lymphocytes were observed predominantly. 4. T helper cells were observed predominantly more than T suppressor/cytotoxic cells in all cases of perapical granulomas. 5. T suppressor/cytotoxic cells were observed predominantly more than T helper cells in 4 cases of periapical cysts (total 5 cases were examined) and only in one case T helper cells were more than T suppressor/cytotoxic cells. 6. In control group, T helper cells were predominant in 2 cases and T helper cells were equivalent to T suppressor/cytotoxic cells in one case. In remaining one case T suppressor/cytotoxic cells were predominant. 7. As the result of DNA analysis, the average proliferating indices of the various groups examined were measured as follows: in the control group 5.45%, in periapical granuloma 6.64%, in periapical cyst 10.1%. The highest index was observed in periapical cyst.

• Archives of Craniofacial Surgery
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• v.13 no.1
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• pp.63-67
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• 2012

Purpose: Lipogranuloma is the reaction of adipose tissue to various oils, paraffin, and other hydrocarbons injected into subcutaneous tissue for cosmetic or other reasons. The authors experienced a case of sclerosing lipogranuloma on the nasal dorsum. Methods: A 42-year-old female, without a history of the injection of any foreign materials, was admitted on our hospital for a painless, irregular, and firm mass located on her nasal dorsum with step-off deformity. It was considered that the mass had developed after augmentation rhinoplasty. The size of mass had been increased after closed reduction of nasal bone fracture. On April 2011, under general anesthesia, the mass was removed by open rhinoplasty technique. In addition, a pathologic examination was performed. After the mass extirpation, dermofat graft was performed for the correction of depression deformity. Results: The histopathological findings demonstrated a Swiss cheese pattern with variably-sized vacuoles, which corresponded to lipid removed with tissue processing, and variable foreign body giant cell reaction, fat necrosis, and hyalinized fibrous tissue. The pathologic diagnosis is lipogranuloma replacing nasalis muscle. It has been considered that sclerosing lipogranuloma is caused by nerve injury during augmentation rhinoplasty and the ointment used after the closed reduction of nasal bone fracture, which infiltrated through the injured mucosa. Conclusion: During the treatment of rhinoplasty or nasal bone fracture, the nerve injury or the ointment use can lead to lipogranuloma. Therefore, careful dissection for avoidance of the nerve injury and limited use of ointment seems to be helpful in decreasing incidence of lipogranuloma.

• Restorative Dentistry and Endodontics
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• v.47 no.1
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• pp.12.1-12.11
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• 2022

Objectives: This pilot study aimed to establish the interrelationship between collagen and mast cells in periapical granulomas and periapical cysts. Materials and Methods: An observational cross-sectional study was conducted on the paraffin-embedded tissue sections of 68 specimens (34 periapical granulomas and 34 periapical cysts). The specimens were stained with picrosirius to observe collagen fiber birefringence and anti-tryptase antibody to evaluate the mast cell count immunohistochemically. The mean number and birefringence of collagen fibers, as well as the mean number of mast cells (total, granulated, and degranulated), and the mean inflammatory cell density were calculated. The data obtained were analyzed using the Kruskal Wallis test, Mann Whitney U test, and Spearman correlation test (p < 0.05). Results: The mean number of thick collagen fibers was higher in periapical cysts, while that of thin fibers was higher in granulomas (p = 0.00). Cysts emitted orange-yellow to red birefringence, whereas periapical granulomas had predominantly green fibers (p = 0.00). The mean inflammatory cell density was comparable in all groups (p = 0.129). The number of total, degranulated, and granulated mast cells exhibited significant results (p = 0.00) in both groups. Thick cyst fibers showed significant inverse correlations with inflammation and degranulated mast cells (p = 0.041, 0.04 respectively). Conclusions: Mast cells and inflammatory cells influenced the nature of collagen fiber formation and its birefringence. This finding may assist in the prediction of the nature, pathogenesis, and biological behavior of periapical lesions.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.164-172
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• 1996

Background : Transforming growth factor-$\beta$(TGF-$\beta$) may play a role in a variety of fibroproliferative disorders including pulmonary fibrosis via the induction of extracellular matrix accumulation. TGF-$\beta$ not only stimulates extracellular matrix production, but also decreases matrix degradation. Interstial lung diseases have demonstrated marked expression of TGF-$\beta$. Methods : To evaluate the possible role of TGF-$\beta$ in human pulmonary fibrosis, by using neutralizing antibody of TGF-$\beta$ we investigated immunohistochemically the expression of TGF-$\beta$ in the formalin-fixed, paraffin-embedded tissue sections of the 5 normal cases for the control, and a couple of pieces of tissues taken out of 3 cases with idiopathic pulmonary fibrosis, 3 cases with ILD from bleomycin toxicity, 3 cases with ILD from sarcoidosis, and 3 cases with ILD from eosinophilic granuloma. Results : In the 5 normal cases for the control, the TGF-$\beta$ was expressed in bronchial and alveolar epithelial cells. Up-regulation of the TGF-$\beta$ expression was showed in the interstitial fibroblast cells of alveolar septa in 5 pieces and proliferated alveolar pneumocytes in 1 piece among 6 pieces tissues taken out of 3 cases with idiopathic pulmonary fibrosis. Also up-regulation of the TGF-$\beta$ expression was showed in alveolar lining pneumocytes, intra-alveolar mononuclear cells, and epithelioid cells in most of cases of ILD from bleomycin toxicity, sarcoidosis and eosinophilic granuloma. Conclusion : These findings suggest that up-regulation of the TGF-$\beta$are involved in pathogenesis of interstitial lung fibrosis from variety of causes.