Grease Gun Granulomas

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Abstract
The clinical and histologic features are described for six cases of grease gun granuloma caused by accidental injection of petroleum lubricant. The lubricant, injected under high pressure, infiltrates and disrupts the tissue. A major histopathologic alteration is the presence of vacuoles or cystic spaces of varying size in the dermis and subcutis that represent the site of the exogenous oil substance. The spaces are lined by epithelioid cells positive in immunohistochemical studies to lysozyme. The surrounding tissue contains macrophages, inflammatory cells, and fibrocytes. Arteries in the involved areas show thrombosis with occlusion that may have induced ischemia and ulceration. Complete excision of the injected area is necessary for healing.

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