Accepted Manuscript Conjunctival Inverted Squamous Papilloma: A Case Report with Immunohistochemical Analysis and Review of the Literature Anna M. Stagner, MD Frederick A. Jakobiec, MD, DSc Anthony Chi, MD, PhD Scott H. Bradshaw, MD Silvino Diaz Mendoza, MD PII:
S0039-6257(14)00221-5
DOI:
10.1016/j.survophthal.2014.10.004
Reference:
SOP 6542
To appear in:
Survey of Ophthalmology
Received Date: 21 September 2014 Revised Date:
17 October 2014
Accepted Date: 31 October 2014
Please cite this article as: Stagner AM, Jakobiec FA, Chi A, Bradshaw SH, Mendoza SD, Conjunctival Inverted Squamous Papilloma: A Case Report with Immunohistochemical Analysis and Review of the Literature, Survey of Ophthalmology (2014), doi: 10.1016/j.survophthal.2014.10.004. This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
ACCEPTED MANUSCRIPT Conjunctival Inverted Squamous Papilloma 1
Conjunctival Inverted Squamous Papilloma: A Case Report with Immunohistochemical Analysis and Review of the Literature Anna M. Stagner MD, 1,2 Frederick A. Jakobiec MD, DSc, 1,2 Anthony Chi MD, PhD,3 Scott H.
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Bradshaw MD,3 Silvino Diaz Mendoza MD.4
David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye & Ear Infirmary,
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Boston, USA
Department of Ophthalmology, Harvard Medical School, Boston, USA
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Department of Pathology, Massachusetts General Hospital, Boston, USA
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Department of Ophthalmology, University of Puerto Rico, San Juan, Puerto Rico
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Running Head: Conjunctival Inverted Squamous Papilloma
Keywords: inverted papilloma; conjunctiva; cytokeratin; immunohistochemistry; Ki67
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Corresponding author:
Frederick A. Jakobiec, M.D., D.Sc.
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David G. Cogan Ophthalmic Pathology Laboratory Massachusetts Eye and Ear Infirmary, Suite 328 243 Charles Street, Boston, MA 02114 Email:
[email protected] Phone: (617)-573-3330
ACCEPTED MANUSCRIPT Conjunctival Inverted Squamous Papilloma 2
ABSTRACT A 63-year-old man presented with an asymptomatic papillary, sessile lesion of the juxtalimbal
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bulbar conjunctiva that was surgically excised with cryotherapy. Histopathologically, the lesion created some diagnostic confusion as it displayed an endophytic or inverted growth pattern with squamous cells pushing into the substantia propria around fibrovascular cores, but without
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significant cytologic atypia, consistent with a conjunctival inverted papilloma (IP). Unlike
previously reported cases of conjunctival IP, there were no goblet cells or cysts within the tumor.
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Immunostaining was diffusely positive for cytokeratin (CK) 7, and CK14 stained the basilar and suprabasilar cells, as in normal conjunctiva. CK17 weakly and non-uniformly stained the tumor, ruling out a dysplasia, which is usually strongly positive. The lesion’s cytokeratin profile therefore paralleled that of normal conjunctiva. The proliferation index with Ki67 nuclear staining was extremely low (