Ramberg Ingvild, Sjö Nicolai Christian, Bonde Jesper Hansen, Heegaard Steffen
Department of Pathology, Section for Eye Pathology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
Department of Ophthalmology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
BMJ Open Ophthalmol. 2019 Feb 28;4(1):e000193. doi: 10.1136/bmjophth-2018-000193. eCollection 2019.
The purpose of the present study is to describe the clinical and histopathological features of conjunctival inverted papilloma, to analyse for the presence of human papillomavirus (HPV), and to determine if HPV infection is associated with this type of tumour and its inverted growth pattern.
Cases of conjunctival inverted papillomas were retrieved from the archives of the Department of Pathology, Rigshospitalet, Denmark. Patient records and pathology reports were reviewed. Formalin-fixed and paraffin-embedded tissue was analysed for the presence of HPV by immunohistochemistry, in situ hybridisation (ISH), PCR and HPV typed by sequencing.
A total of four cases were retrieved. The age at diagnosis ranged from 41 to 77 years, with an equal sex distribution. All lesions were localised to the bulbar conjunctiva and two of the cases were pigmented. Histopathological examination did not reveal areas of dysplasia. All lesions were p16-positive and p53-positive by immunohistochemistry. High-risk HPV 58 was demonstrated in one lesion by ISH and PCR.
Here we present four cases of conjunctival inverted papilloma, which is an exceedingly rare tumour with only 11 previously reported cases in the literature. Both clinically and histopathologically, the tumours show distinct features compared with exophytic conjunctival papillomas. Furthermore, this is the first description of high-risk HPV 58 in a conjunctival tumour. The biological behaviour of the tumour is uncertain due to its rareness. However, a complete removal of the lesion and a careful observation are recommended. The finding of HPV 58 underlines the necessity of this precaution.
本研究旨在描述结膜内翻乳头状瘤的临床和组织病理学特征，分析人乳头瘤病毒（HPV）的存在情况，并确定HPV感染是否与这类肿瘤及其内翻生长模式相关。
从丹麦里格霍斯医院病理科档案中检索结膜内翻乳头状瘤病例。查阅患者记录和病理报告。采用免疫组织化学、原位杂交（ISH）、聚合酶链反应（PCR）对福尔马林固定石蜡包埋组织进行HPV检测，并通过测序对HPV进行分型。
共检索到4例病例。诊断时年龄在41至77岁之间，性别分布均衡。所有病变均位于球结膜，其中2例有色素沉着。组织病理学检查未发现发育异常区域。免疫组织化学显示所有病变p16和p53均呈阳性。ISH和PCR在1例病变中检测到高危型HPV 58。
我们在此报告4例结膜内翻乳头状瘤，这是一种极为罕见的肿瘤，文献中此前仅报道过11例。在临床和组织病理学方面，与外生性结膜乳头状瘤相比，这些肿瘤具有明显特征。此外，这是首次在结膜肿瘤中描述高危型HPV 58。由于其罕见性，该肿瘤的生物学行为尚不确定。然而，建议完整切除病变并仔细观察。HPV 58的发现强调了这种预防措施的必要性。
