Histologically, chalazion shows a typical appearance of lipogranulomatous reaction - a form of chronic inflammatory reaction. Once you have made the diagnosis, the examiner usually moves to a discussion of cells that are seen in chronic inflammation especially the types of giant cells which may give clue to the underlying condition.

The features to look for are:

  • multiple inflammatory cells surrounding clear spaces (the clear space is the result of lipid which has been removed during processing).
  • presence of multinucleated giant cells.

Low magnification H&E
Presence of inflammatory cells surrounding a clear space 
(where lipid has been removed during tissue preparation). 
The inflammation is a foreign body response to lipid that 
leaks out of sebaceous glands or the glands of Zeiss.

High magnification H & E
Giant cells (arrowed) in chalazion.

Common questions in the viva:
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