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DISEASE: Conjunctival squamous cell papilloma
PATHOGENESIS: Most commonly associated with HPV 6 and 11. Sessile papillomas associated with HPV 16 and 18.
HISTOLOGY FEATURES: Pedunculated papillomas are exophytic, pink-red papillary growths. Papillary fibrovascular fronds covered with hyperplastic squamous epithelium. Number of goblet cells may be reduced if there is overlying tear-film disruption.
OCULAR FEATURES: Pedunculated papilloma more common in children. Sessile papilloma arising from bulbar conjunctiva adjacent to the limbus more common in adults.
OTHER FEATURES: Exhibit benign behavior. May spontaneously involute over time. Concerning features of sessile papilloma suggestive of neoplasia include leukoplakia and inflammation.
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