METAPLASIA

• Metaplasia is a reversible change in which one differentiated cell

type (epithelial or mesenchymal) is replaced by another cell type

Metaplasia is a reversible change.

• Types:
 Epithelial metaplasia
 Connective tissue metaplasia
METAPLASIA : Most common epithelial metaplasia is columnar to
squamous
Examples:
In habitual cigarette smoker, Respiratory epithelium --------> stratified
squamous epithelium .
Stones in the excretory ducts , secretory columnar epithelium ---stratified
squamous epithelium.
A deficiency of vitamin A (retinoic acid) --------> squamous metaplasia in the respiratory epithelium.
Chronic inflammation of cervix : Endocervical ----> Squamous epithelium.

Stratified squamous epithelium is able to survive under circumstances in which the more
fragile specialized columnar epithelium might not.
 METAPLASIA
• BUT
• Squamous metaplasia in the respiratory tract epithelium results in
loss of :
 Mucous secretion &
 Ciliary action ------------> Infections

• Epithelial metaplasia is a double-edged sword.

• Undesirable change.
• Influences that predispose to metaplasia, if persistent, may
initiate malignant transformation in metaplastic epithelium.

• In respiratory tract Metaplastic squamous epithelium --->

Dysplasia----------> Squamous cell carcinoma
 METAPLASIA
 Metaplasia from squamous to
columnar type may also
occur.

 Barrett esophagus-----
>Esophageal squamous
epithelium at gastroesphageal
junction-------> intestinal-like
columnar cells under the
influence of refluxed gastric
acid.

 Cancers (adenocarcinomas)
 may arise in these areas
 METAPLASIA
 Connective tissue metaplasia :

• Formation of cartilage, bone, or adipose tissue in tissues that normally

do not contain these elements.

• For example, bone formation in muscles occasionally occurs after

intramuscular hemorrhage , designated as myositis ossificans,

• This type of metaplasia is less clearly seen as an adaptive response,

and may be a result of cell or tissue injury.
 METAPLASIA
 Mechanisms of Metaplasia
• Metaplasia is not a change in the phenotype of an already
differentiated cell .

• It 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.
Types of Cellular Adapatation
 MCQs
• Q.1 A 45 -year-old woman is investigated for
hypertension and is found to have enlargement of the left
kidney. The right kidney is smaller than normal. Contrast
studies reveal stenosis of the right renal artery. The size
change in the right kidney is an example of which of the
following adaptive changes?

a) Aplasia
b) Atrophy
c) Hyperplasia
d) Hypertrophy
e) Metaplasia
 MCQs

• Q.2 A 43-year-old man has been suffering from mild burning sub
sternal pain following meals for the past 3 years. Upper GI endoscopy
is performed and biopsies are taken
• The biopsies show the presence of columnar epithelium with goblet
cells. Which of the following mucosal alterations is most likely
represented by these findings?

a) Hyperplasia
b) Dysplasia
c) Carcinoma i
d) Metaplasia
e) Anaplasia
 
 MCQs
• Q.3 Enlargement of uterus during pregnancy is an example of
which of the following adaptive changes?

a) Compensatory hyperplasia
b) Hormonal hyperplasia
c) Pathologic hyperplasia
d) Pathological Hypertrophy
e) Metaplasia