Case Number : Case 2609 - 07 July 2020 Posted By: Uma Sundram

verruca ?

Seems like full thickness dysplasia- squamous cell carcinoma in situ. Sebaceous differentiation not apparent, but because of location sebaceous carcinoma in situ also to be considered. 

Exophytic growth of papillary, well differentiated, acanthotic nonkeratinized transitional/squamous cells, with some goblet cells. I see  prominent, branching fibrovascular cores, with some hobnail hemangioma-like appearance, probably reactive. Favor Conjunctival Papilloma. 

I think this is a warty lesion of Bowen's disease.

Just noticed the age of the patient which makes ordinary Bowen's disease unlikely.  Perhaps this is HPV induced, but an unusual site.

Conjunctival papilloma. I agree that some atypia is present, and the degree of atypia is definitely debatable. You may note that while the cells are hyperchromatic, they are well organized. Age of patient makes irritation related reactive papilloma more likely than SCCIS.