Human papillomavirus infection of the esophagus. A clinicopathologic study with demonstration of papillomavirus antigen by the immunoperoxidase technique.

Papillomaviruses are known to be oncogenic in animals. In humans they are associated with benign squamous tumors (verruca, condylomata acuminata, and papillomas) in a variety of body sites. Human papillomavirus (HPV) infection of the esophagus, however, has not previously been documented. Recent reports of condylomatous changes in esophageal epithelium adjacent to esophageal carcinoma and the sporadic descriptions of esophageal papillomas in the literature for many years, lend credence to the assumption that HPV may affect the squamous mucous membrane of the esophagus. In the current study 75 cases, including 2 papillomas and 73 focal epithelial hyperplasia of the esophagus, were examined for histologic evidence of HPV infection as characterized by the presence of koilocytosis, giant and multinucleated cells, dyskeratosis, hyperkeratosis, acanthosis, papillomatosis, and anisonucleosis. Thirteen of the cases--the 2 papillomas and 11 of the focal epithelial hyperplasias--contained distinctive histologic evidence of HPV infection. The presence of HPV antigens was demonstrated by immunoperoxidase (IMPO) in the 4 of the 13 cases (31%). In the remaining cases the IMPO was equivocal in two and negative in seven.