title: Human papillomavirus: cause of epithelial lacrimal sac neoplasia?
abstract: OBJECTIVE
  Epithelial tumours of the lacrimal sac are rare but important entities that may carry grave prognoses. In this study the prevalence and possible role of human papillomavirus (HPV) infection in epithelial tumours of the lacrimal sac were evaluated.
  
  
  METHODS
  Five papillomas and six carcinomas of the lacrimal sac were investigated for the presence of HPV using the polymerase chain reaction (PCR) technique. Fifteen specimens of dacryocystitis were included in the PCR reactions as controls. Furthermore, DNA in situ hybridization (ISH) and RNA ISH were performed.
  
  
  RESULTS
  Low-risk HPV types 6 or 11 were identified in all four lacrimal sac papillomas suitable for PCR analysis and in situ hybridization. Four of six lacrimal sac carcinomas harboured HPV. One carcinoma was positive for HPV 11 only, two carcinomas had concomitant infection with HPV 6 or 11 and high-risk HPV 16, and the remaining carcinoma was positive for HPV 16. All specimens of dacryocystitis were betaglobin-positive and HPV-negative. Using DNA ISH, two papillomas and a single carcinoma showed evidence for vegetative HPV 11 DNA replication, whereas no HPV 16 DNA replication was found in the five carcinomas tested. HPV 11 RNA was demonstrated in two papillomas.
  
  
  CONCLUSIONS
  By analysing 11 epithelial lacrimal sac papillomas and carcinomas using PCR, DNA ISH and RNA ISH, we found HPV DNA in all investigated transitional epithelium tumours of the lacrimal sac. HPV RNA was present in two of eight epithelial lacrimal sac tumours positive for HPV DNA. As RNA degrades fast in paraffin-embedded tissue, only a small fraction of DNA-positive tumours can be expected to be RNA-positive. We therefore suggest that HPV infection is associated with the development of lacrimal sac papillomas and carcinomas.
authors.affiliation: Eye Pathology Institute, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Nicolai Christian
authors.initials: NC
authors.lastname: Sjö
authors.forename: Christian
authors.initials: C
authors.lastname: von Buchwald
authors.forename: Patricia
authors.initials: P
authors.lastname: Cassonnet
authors.forename: Patricia
authors.initials: P
authors.lastname: Flamant
authors.forename: Steffen
authors.initials: S
authors.lastname: Heegaard
authors.forename: Bodil
authors.initials: B
authors.lastname: Norrild
authors.forename: Jan Ulrik
authors.initials: JU
authors.lastname: Prause
authors.forename: Gerard
authors.initials: G
authors.lastname: Orth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001345:Autoradiography; D002277:Carcinoma / Q000821:virology*; D002294:Carcinoma, Squamous Cell / Q000821:virology; D002295:Carcinoma, Transitional Cell / Q000821:virology; D004261:DNA Replication; D004279:DNA, Viral / Q000032:analysis; D005134:Eye Neoplasms / Q000821:virology*; D005260:Female; D052140:Human papillomavirus 11 / Q000235:genetics / Q000302:isolation & purification*; D052163:Human papillomavirus 6 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D017403:In Situ Hybridization; D007766:Lacrimal Apparatus Diseases / Q000821:virology*; D008297:Male; D008875:Middle Aged; D010212:Papilloma / Q000821:virology*; D030361:Papillomavirus Infections / Q000821:virology*; D016133:Polymerase Chain Reaction; D012367:RNA, Viral / Q000032:analysis
chemical_list: D004279:DNA, Viral; D012367:RNA, Viral