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Morphological characteristics of conjunctival squamous papillomas in relation to human papillomavirus infection
  1. Jernej Mlakar1,
  2. Boštjan J Kocjan2,
  3. Lea Hošnjak2,
  4. Jože Pižem1,
  5. Matej Beltram3,
  6. Nina Gale2,
  7. Brigita Drnovšek-Olup3,
  8. Mario Poljak2
  1. 1Faculty of Medicine, Institute of Pathology, University of Ljubljana, Ljubljana, Slovenia
  2. 2Faculty of Medicine, Institute of Microbiology and Immunology, University of Ljubljana, Ljubljana, Slovenia
  3. 3Eye Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
  1. Correspondence to Dr Jernej Mlakar, Faculty of Medicine, Institute of Pathology, University of Ljubljana, Korytkova 2, Ljubljana 1000, Slovenia; jernej.mlakar85{at}


Objective To determine the prevalence of a broad spectrum of human papillomavirus (HPV) types in conjunctival papillomas and a possible difference in clinical and histopathological presentation of HPV-positive and HPV-negative papillomas.

Methods Formalin-fixed, paraffin-embedded papilloma tissue specimens obtained from 25 patients were analysed using six different PCR-based methods targeting 87 HPV types from four different papillomavirus (PV) genera: α-PV, β-PV, γ-PV and µ-PV, and in situ hybridisation for HPV-6/HPV-11. Slides were reviewed for pedunculated or sessile growth, the presence of goblet cells, keratinising or non-keratinising epithelium, elastosis, atypia and koilocytes.

Results α-PV types HPV-6 and HPV-11 were detected in 19/25 (76%) conjunctival papilloma tissue specimens, 9 (47%) of which were also HPV-6/HPV-11 positive with in situ hybridisation. Six different β-PV types—HPV-9, HPV-12, HPV-20, HPV-21, HPV-22, HPV-24—were additionally detected in four cases, all of which were also HPV-6/HPV-11 positive. No γ-PVs or µ-PVs were found in any of the tested tissues samples. Extralimbal location (p=0.021), presence of goblet cells (p=0.005), non-keratinising squamous epithelium (p=0.005), and absence of elastosis (p=0.005) were associated with the presence of HPV-6/HPV-11.

Conclusions We demonstrated that certain clinical and histological features are more frequently associated with HPV infection and that HPV genera other than α-PV are most probably not significant factors in conjunctival papilloma occurrence.

  • Conjunctiva
  • Infection
  • Microbiology
  • Neoplasia
  • Pathology

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