콩다래끼로 오인되었던 8세 여아의 합성섬유육아종
Synthetic Fiber Granuloma Misdiagnosed as Chalazion in an 8-year-old Child
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목적: 콩다래끼로 오인되었던 결막 합성섬유육아종 1예의 증례를 경험하고 치료하였기에 이에 대해 보고하고자 한다. 증례요약: 특별한 내과병력 및 외상력이 없는 8세 여아가 좌안 하안검 결막에 지속되는 종괴로 본원으로 의뢰되었다. 환아의 시력 및 안압은 정상이었고 평소 자주 인형 머리카락을 가위로 자르며 놀았다고 하였다. 결막종괴는 개인의원 내원 1주일 전에 처음 발생하여 콩다래끼 진단하에 안약 점안치료를 시행하였으나 호전이 없어 절개 및 소파술을 시행하였고, 그 이후에도 결막내 종괴가 지속되는 양상으로 조직검사를 위해 본원으로 전원되었다. 본원 내원 후 시행한 세극등현미경검사상 종괴 내부에 섬유 가닥의 엉김과 같은 양상이 관찰되었다. 전신마취하에 절제생검을 시행하였고 조직병리학적 검사상 복굴절의 섬유 이물과 그를 둘러싼 육아종성 염증이 관찰되어 합성섬유육아종이 진단되었다. 결론: 결막 합성섬유육아종은 콩다래끼로 오인되기 쉬우며 세극등현미경검사상 종괴 내부에 특이적인 섬유 가닥의 엉김이 관찰될 경우 임상적 의심하에 치료적 절제생검을 통한 진단 및 치료가 필요하다.
Abstract
Purpose: We report a case of conjunctival synthetic fiber granuloma, which was misdiagnosed as chalazion. Case summary: An 8-year-old female patient, without any previous medical illness or ocular trauma history, visited our hospital with a prolonged mass-like lesion in the left lower palpebral conjunctiva. In her detailed medical history, she said that she often played with her doll's hair. The conjunctival mass first occurred 1 week before her visit to the private clinic. At that time, eye drop treatment was initiated under the diagnosis of chalazion. The child showed no improvement; thus, incision and curettage were performed. The mass in the conjunctiva continued to persist, so she was transferred to the hospital for a biopsy. Slit-lamp examination revealed a patterned agglomeration of fiber strands inside the mass. Complete excisional biopsy was performed under general anesthesia. Histopathological examination revealed a fibrous foreign body in the birefringence, with granulomatous inflammation surrounding it. The patient was diagnosed with synthetic fiber granuloma. Conclusions: Conjunctival synthetic fiber granulomas are easily mistaken as chalazion. If specific fibrous strands are entangled inside the mass on slit-lamp examination, diagnosis and treatment through therapeutic excisional biopsy are required under clinical suspicion.
참고문헌 (10)
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