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Metaplasia and Dysplasia: By/Dr - Abdisamad Omar Ali

Metaplasia is a change in cell type in response to stress, such as acid reflux causing the esophagus to change from squamous to columnar cells. This change, seen in Barrett's esophagus, is reversible but can progress to dysplasia and cancer if the stress persists. Dysplasia is the proliferation of precancerous cells, such as in cervical intraepithelial neoplasia, and is reversible but can become carcinoma if not treated. Metaplasia and dysplasia are important precursors to various cancers that arise from prolonged pathological stresses and hyperplasias.

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19 views31 pages

Metaplasia and Dysplasia: By/Dr - Abdisamad Omar Ali

Metaplasia is a change in cell type in response to stress, such as acid reflux causing the esophagus to change from squamous to columnar cells. This change, seen in Barrett's esophagus, is reversible but can progress to dysplasia and cancer if the stress persists. Dysplasia is the proliferation of precancerous cells, such as in cervical intraepithelial neoplasia, and is reversible but can become carcinoma if not treated. Metaplasia and dysplasia are important precursors to various cancers that arise from prolonged pathological stresses and hyperplasias.

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SAKARIYE MAXAMED
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METAPLASIA AND DYSPLASIA

By/Dr.Abdisamad omar ali


Metaplasia
 A change in stress on an organ leads to a change in
cell type (metaplasia)

1. Most commonly involves change of one type of


surface epithelium (squamous, columnar, or
urothelial) to another

2. Metaplastic cells are better able to handle the new


stress
Cellular defferentiation
Metaplasia (new mature cell)
Environmental stressor
Mature columnar epithelial cells
Stratified squamous epithelial cells
Barrett esophagus
 Barrett esophagus is a classic example

1. Esophagus is normally lined by nonkeratinizing


squamous epithelium (suited lo handle friction of a
food bolus)

2. Acid reflux from the stomach causes metaplasia to


nonciliated, mucin-producing columnar cells (better
able to handle the stress of acid)
Metaplasia (esophagus)
GERD (metaplasia)
GERD (metaplasia)
Barretts esophagus
Barretts esophagus
Metaplasia
 Metaplasia occurs via (programming of stem
cells) which then produce the new cell type

1. Metaplasia is reversible, with removal of the


driving stressor

2. For example, treatment of gastroesophageal


reflux may reverse Barrett esophagus
Metaplasia
 Under persistent stress, metaplasia can progress to
dysplasia and eventually result in cancer

1. For example, Barrett esophagus may progress So


adenocarcinoma of the esophagus

2. A notable exception is apocrine metaplasia of


breast, which carries no increased risk for cancer
Vitamin A deficiency
1. Vitamin A is necessary for differentiation of
specialized epithelial surfaces such as the
conjunctiva covering the eye

2. In vitamin A deficiency, the thin squamous lining of


the conjunctiva undergoes metaplasia into stratified
keratinizing squamous epithelium

 This change is called keratomalacia


Mesenchymal tissues

 Mesenchymal (connective) tissues


can also undergo metaplasia

1. A classic example is myositis


ossificans in which muscle tissue
changes to bone during healing after
trauma
Keratomalacia / myositis ossificans
Dysplasia
 Definition : disordered cellular growth

 Most often refers to proliferation of precancerous cells

 For example, cervical intraepithelial neoplasia (CIN) represents dysplasia


and is a precursor to cervical cancer

 Dysplasia of cervix and esophagus often arises from longstanding pathologic


hyperplasia (endometrial hyperplasia) or metaplasia (Barrett esophagus)

 Dysplasia is reversible, with alleviation of inciting stress

 If stress persists, dysplasia progresses to carcinoma (irreversible)


Pathological changes (dysplasia)
Pathological changes (dysplasia)
Dysplasia (cervix)
Human papilloma virus
Carsinoma in situ
Invasive cervical carcinoma
Cervical Cancer

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