Metaplasia

DEF: Metaplasia is a reversible change in which one differentiated cell type (epithelial or mesenchymal) is replaced by another cell type. It may represent an adaptive substitution of cells TYPE : The most common epithelial metaplasia is columnar to squamous 1. Epithelial metaplasia : 2 edged sowrd benefit- surviving against injurious agent, harm: fertile soil for malignant transformation [by persistence influence of metaplasia] A) Squamous metaplasia a) columner cell to squamaous cell - resp : Pseudo stratified ciliated Columnar cell > Stratified squamous.eg. smoker,COPD - GB : Columner > Squamous in chr. Cholecystitis - Uterus: Columner > Squamous in cervicitis endometrium occasionally - Prostate: C>S in BEP - Vit A deficiency: epi of resp,genitourinary, conjunctiva undergo squamous metaplasia - Duct of pancreas/salivary gland: normal secretory columner non functioning Str.squa epi b) Transitional to squamous - Urinary bladder: in Chr. Inflammation,calculi, schistosomiasis B) Columner metaplasia a) Intestinal metaplasia: epi of stomach replace by colonic epi. Liable for malignancy b) Barrets esophagus: Squamous epi replaced by intestinal like columner cell. Risk: adeno Ca c) Cervical erosion: vaginal cervix(squamous) replaced by columner cell d) Respiratory: Pseudostratified columner ciliated to simple mucous secreting in chr.bronchitis, bronchiectasis

2. Connective tissue metaplasia A) Osseus metaplasia: Fibroblast to osteoblast a) Aging of cartilage costal,thyroid b) Soft tissue scar,dystrophic calcification, caseous foci c) Myositis ossificans in muscle due to trauma, after supracondylar # in bending elbow (after intramuscular hemorrhage) B) Mesothelium: Squamous metaplasia in the pleura & peritoneum Mechanism: is the result of a reprogramming of stem cells - that are known to exist in normal tissues, or - of undifferentiated mesenchymal cells present in connective tissue. The differentiation of stem cells to a particular lineage is brought about by signals generated by cytokines, growth factors, and extracellular matrix components in the cells' environment or, the reserve cells (or stem cells) of the irritated tissue differentiate into a more protective cell type due to the influence of growth factors, cytokines, and matrix components

bad development. increase in growth of immature cells which reduces the growth of mature cells.

change of form. cell of specific type is replaced by another cell of another different shape.

Difference Between Dysplasia and Metaplasia The word Dysplasia is derived from a greek term meaning bad development. Metaplasia has derived its meaning from an another greek word meaning change of form. It is the process in which a cell of specific type is replaced by another cell of another different shape. Dysplasia is usually characterized by increase in growth of immature cells which reduces the growth of mature cells. Dysplasia is an indication of a young neo-plastic progression. It refers directly to the state of the cellular defect limited within the tissue of origin, for example, tumor. Cell transformations in metaplasia are often a result of the start of unusual stimulus. In this case, the original cells are not strong enough to live in the new environment that consists of unknown and unusual stimuli. There are four different stages of pathological change in dysplasia. Dysplasia and metaplasia are two different issues and not synonymous. Metaplasia are carcinogenic in nature. In contrast to dysplasia, metaplasia is caused due to stimulus and the same is responsible for the transformation. Cervical dysplasia is often caused by cervical infections.. The virus related to this infection is the virus that leads to other aspects of condyloma or genital warts. The virus is transmitted through sexual intercourse also. Sex with multiple partners increases the chances that women will become infected with HPV. The virus infects the cells lining the vagina and reproductive system of women. Although metaplasia occurs when normal cells face severe stress from a physiological and pathological forms. In such a state of stressed cells begin to adapt to changing situations with non-cancerous cell growth

Summary :.

1 Dysplasia is a pathologic term used to refer to errors that prevent cell growth within a given tissue, but metaplasia is the process of replacement of specific types of cells with other cells of corresponding maturity in different species. 2 Dysplasia is cancer and metaplasia are not cancer. 3. If the unusual stimulus is removed then metaplasia can be stopped, but dysplasia is a non-reversible process.

4. Dysplasia is pre-cancer Dysplasia refers to any disordered growth and maturation of an epithelium, which is still reversible if the factors driving it are eliminated. The description is similar to that of metaplasia, but there are several key differences. Metaplasia is not considered a part of carcinogenesis, and while dysplasias show a delay in maturation/differentiation of cells within tissues (e.g., expansion of immature cells with a corresponding decrease in number/change in location of mature cells), metaplasias have cells of one mature/differentiated type replace cells of another mature/differentiated type. Another way to describe dysplasias is by pathology: dysplasia is often the earliest form of pre-cancerous lesion recognizable in a pap smear or in a biopsy by a pathologist. Dysplasias can be low grade or high grade. The risk of a low-grade dysplasia transforming into a high-grade dysplasia (and eventually to cancer) is low. "High-grade dysplasia" is often synonymous with "carcinoma in situ." These dysplasias represent a more advanced progression towards malignant transformation, and the risk of high-grade dysplasias transforming into cancer is high. When the entire epithelium is dysplastic and no normal epithelial cells are present, the growth is termed a neoplasia

4. Hyperplasia

a. Definition: an increase in the number of cells in a tissue or organ b. Some cell types are unable to exhibit hyperplasia (e.g., nerve, cardiac, skeletal muscle cells) c. Physiologic causes of hyperplasia i. Compensatory e.g. - after partial hepatectomy - after unilateral nephrectomy ii. Hormonal stimulation e.g. - glandular epi breast development at puberty & Pg - Pg uterus iii. Antigenic stimulation (e.g.,lymphoid hyperplasia) d. Pathologic causes of hyperplasia i. Endometrial hyperplasia ii. Prostatic hyperplasia of aging of thyroid gland skin warts (epidermal hyperplasia) due to pappiloma virus in healing process e. Hyperplasia is mediated by i. Growth factors, cytokines, and other trophic stimuli ii. Increased expression of growth-promoting genes (proto-oncogenes) iii. Increased DNA synthesis and cell division (mitotic division) 3, Mechanisms of hyperplasia a. Dependent on the regenerative capacity of different types of cells b. Labile cells (stem cells) (1) Divide continuously (may form new cell) Labile/stable (2) Examplesstem cells in the bone marrow, stem cells in the crypts of cells; can Lieberkuhn, and basal cells in the epidermis (3) May undergo hyperplasia as an adaptation to cell injury Divide
Permanent cells; cant

c. Stable cells (resting cells) (1) Divide infrequently, because they are normally in the G0, (resting) phase (2) Must be stimulated (e.g., growth factors, hormones) to enter the cell cycle (3) Exampleshepatoeytes, astrocytes, smooth muscle cells (4) May undergo hyperplasia or hypertrophy as an adaptation to cell injury d. Permanent cells (nonreplicating cells) (1) Highly specialized cells that cannot replicate (2) Examplesneurons and skeletal and cardiac muscle cells 4, Inereased risk for progressing into dysplasia and cancer, in some cases (see later) Example-endometrial hyperplasia