title: Medically uncontrolled conjunctival pyogenic granulomas: correlation between clinical characteristics and histological findings.
abstract: BACKGROUND
  Conjunctival pyogenic granulomas are commonly seen after ocular surgeries or at an ocular wound site. The aim of this study is to describe a novel histological classification for medically uncontrolled conjunctival pyogenic granulomas (MUCPG), and to explore whether the diversity in clinical features correlates to different histological subtypes of MUCPG.
  
  
  METHODS
  This is an observational cross-section case series. We reviewed 46 consecutive patients with conjunctival pyogenic granulomas who did not respond to topical corticosteroids and underwent surgical excision from January 1, 2006 through December 31, 2015. Clinical features and histological findings were presented and analyzed.
  
  
  RESULTS
  Ocular surgery, accidental injury, and chalazion were the main predisposing causes of MUCPG. The lesions tended to occur unilaterally on the bulbar conjunctiva. Forty patients (87%) presented an enrichment of inflammatory cells and proliferated capillaries in their pathological sections (inflammatory pattern). Six patients (13%) showed relatively few inflammatory cells and capillaries within fibrous stroma (fibrous pattern). Patients with the inflammatory pattern were older (p = 0.025) and tended to be located in bulbar conjunctiva (p = 0.002). The predisposing causes were also different between two histological subtypes (p = 0.007).
  
  
  CONCLUSIONS
  We found the correlation between clinical presentation and histological subtypes in patients with MUCPG, indicating this disease may need a new classification scheme.
authors.affiliation: Department of Ophthalmology and Visual Science and Eye Research Institute, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Dan
authors.initials: D
authors.lastname: Wu
authors.affiliation: Department of Immunology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Tingting
authors.initials: T
authors.lastname: Qian
authors.affiliation: Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakao
authors.affiliation: Department of Ophthalmology and Visual Science and Eye Research Institute, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Jianjiang
authors.initials: J
authors.lastname: Xu
authors.affiliation: Eye Institute of Xiamen University Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China.|Eye Center and Department of Ophthalmology, The Second Xiangya Hospital and Eye Hospital, Central South University, Hunan, China.
authors.forename: Zuguo
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Department of Ophthalmology and Visual Science and Eye Research Institute, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.|Key Laboratory of Myopia, National Health and Family Planning Commission, Shanghai, China.
authors.forename: Xinghuai
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Immunology, Shanghai Medical College, Fudan University, Shanghai, China.
authors.forename: Yiwei
authors.initials: Y
authors.lastname: Chu
authors.affiliation: Department of Ophthalmology and Visual Science and Eye Research Institute, Eye, and ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, China.|Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, USA.|Eye Institute of Xiamen University Fujian Provincial Key Laboratory of Ophthalmology and Visual Science, Xiamen, Fujian, China.
authors.forename: Jiaxu
authors.initials: J
authors.lastname: Hong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003228:Conjunctiva / Q000473:pathology; D003229:Conjunctival Diseases / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology* / Q000628:therapy; D003430:Cross-Sectional Studies; D004198:Disease Susceptibility; D005260:Female; D017789:Granuloma, Pyogenic / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult
keywords: Pathology Section; clinical characteristic; histology; pyogenic granulomas