Case Study: April 2017


A 30 year old female with a history of nasal papillomas present with epiphora and a lacrimal sac mass. She undergoes biopsy of this mass and the figures illustrate the key pathology.


1. What do the figures show?

2. Which type of lesion is this?

3. Are there any viral associations?


Click to show answers


1. A papillary lesion with fibro-vascular cores , draped in transitional type, non-dysplastic epithelium. The epithelium contains numerous neutrophils and the stroma is inflamed and oedematous.

2. This is a transitional cell papilloma of the lacrimal sac.

3. Some of these lesions are associated with HPV6 (low risk non-oncogenic type HPV’s).


Evaluation for High-risk HPV in Squamous Cell Carcinomas and Precursor Lesions Arising in the Conjunctiva and Lacrimal Sac. Afrogheh AH, Jakobiec FA, Hammon R, Grossniklaus HE, Rocco J, Lindeman NI, Sadow PM, Faquin WC.Am J Surg Pathol. 2016 Apr;40(4):519-28

Transitional cell neoplasm of the nasolacrimal duct associated with human papillomavirus type 11. Vickers JL, Matherne RJ, Allison AW, Wilkerson MG, Tyring SK, Bartlett BL, Rady PL, Kelly BC.J Cutan Pathol. 2010 Jul;37(7):793-6.