title: Conjunctival granulomas caused by synthetic fibers: report of two cases and review of literature.
abstract: OBJECTIVE
  We sought to demonstrate the histopathologic and ultrastructural features of conjunctival foreign body granulomas because of synthetic fibers and to compare them to other cases published in the literature.
  
  
  METHODS
  A 2- and a 7-year-old girl were referred for the surgical removal of slow-growing unilateral inferior conjunctival masses with a lack of primary trauma or surgery. In this report, we describe the light and electron microscopic findings of the 2 cases and review the literature of similar cases using the Medline database.
  
  
  RESULTS
  Histopathologic and ultrastructural examination of both specimens revealed a granulomatous inflammatory cell response, including histiocytes and multinucleated foreign body giant cells around acellular, uniform sized, oval to round birefringent fibers with manufacturing artifacts. Thirteen other patients with conjunctival synthetic fiber granulomas were identified from the literature.
  
  
  CONCLUSIONS
  On the basis of the findings in our cases and the review of literature, it appears that conjunctival synthetic fiber granulomas are not a rare entity but are not recognized frequently by ophthalmologists. The most reliable clinical sign to suggest this diagnosis is the presence of a unilateral inferior conjunctival mass in a child or adolescent. Histopathologic and ultrastructural evaluation appears to be the only way to specifically diagnose this condition with certainty.
authors.affiliation: Emory Eye Center, Emory University School of Medicine, Atlanta, Georgia 30322, USA.
authors.forename: Ingo
authors.initials: I
authors.lastname: Schmack
authors.forename: Shin J
authors.initials: SJ
authors.lastname: Kang
authors.forename: Hans E
authors.initials: HE
authors.lastname: Grossniklaus
authors.forename: Scott R
authors.initials: SR
authors.lastname: Lambert
mesh_terms: D002648:Child; D002675:Child, Preschool; D003229:Conjunctival Diseases / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D005129:Eye Foreign Bodies / Q000150:complications* / Q000473:pathology / Q000601:surgery; D005260:Female; D015726:Giant Cells / Q000473:pathology; D015745:Granuloma, Foreign-Body / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D006644:Histiocytes / Q000473:pathology; D006801:Humans; D008855:Microscopy, Electron, Scanning