Departments of Ophthalmology.
Pathology, New York University Langone Medical Center, New York, New York.
Ophthalmic Plast Reconstr Surg. 2021;37(5):e179-e181. doi: 10.1097/IOP.0000000000001983.
Conjunctival papillomas are common tumors that exhibit an exophytic growth pattern, comprised of multiple filiform fronds of squamous epithelium that contain fibrovascular cores. The inverted (endophytic) variety of papilloma, often termed "Schneiderian," rarely occurs on the conjunctiva, with only 15 cases reported to date. Endophytic and exophytic papillomas are well described arising in the sinonasal Schneiderian epithelium where a low rate of malignant transformation may occur in the endophytic type; malignant transformation in exophytic sinonasal papillomas is exceedingly rare. The authors describe 2 cases of exophytic conjunctival papillomas with the morphology of a sinonasal or Schneiderian-type papilloma. Both were pink, sessile acquired growths in women in the sixth decade of life involving the inferior conjunctival fornix or nasal limbus. Nonkeratinizing squamous epithelium along with numerous goblet cells, intraepithelial mucinous cysts, and microabscesses were present. Immunohistochemistry showed reactivity for cytokeratin 7 and wild-type staining for p16 and p53, paralleling the findings in common conjunctival papillomas; both were also driven by low-risk human papillomavirus.
结膜乳头瘤是常见的外生性生长肿瘤，由多个含有纤维血管核心的鳞形上皮丝状小叶组成。内翻（内生）型乳头瘤，常被称为“Schneiderian 型”，在结膜上很少见，迄今为止仅报告了 15 例。内翻和外生乳头瘤在鼻窦的 Schneiderian 上皮中描述得很好，其中内生型可能发生恶性转化的发生率较低；外生性鼻窦乳头状瘤的恶性转化极为罕见。作者描述了 2 例具有鼻窦或 Schneiderian 型乳头瘤形态的外生性结膜乳头瘤。这 2 例均为女性，60 岁左右，累及下结膜穹窿或鼻侧缘，呈粉红色、无蒂获得性生长。存在非角化鳞状上皮和大量杯状细胞、上皮内粘蛋白囊肿和微脓肿。免疫组织化学显示细胞角蛋白 7 反应性和野生型 p16 和 p53 染色，与常见的结膜乳头瘤的发现一致；这 2 例也由低危型人乳头瘤病毒驱动。
