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Zorluk: KolayCellular Injury and Adaptation

A 54-year-old man with a 10-year history of uncontrolled gastroesophageal reflux disease undergoes an upper gastrointestinal endoscopy. A biopsy of the distal esophagus is obtained. Histologic examination of the tissue reveals the replacement of the normal stratified squamous epithelium with nonciliated, mucin-producing columnar epithelium containing goblet cells. No cytologic atypia is observed. Which of the following cellular processes best describes this histologic finding?

  1. MetaplasiaCevap
  2. B
    Dysplasia
  3. C
    Hyperplasia
  4. D
    Hypertrophy
  5. E
    Anaplasia

Cevap

The correct cellular process is Metaplasia.
The histologic finding of one adult cell type (stratified squamous) being replaced by another adult cell type (columnar with goblet cells) in response to chronic acid irritation is the exact definition of metaplasia. This specific presentation describes Barrett esophagus.

Adım Adım Çözüm

1
Analyze the patient's history and the anatomical site of the biopsy.
The patient has chronic gastroesophageal reflux disease (GERD), providing a source of chronic acid irritation to the distal esophagus.
Identifying the chronic stressor is necessary to determine the expected physiologic or pathologic tissue response.
2
Evaluate the specific histologic changes described in the vignette.
Normal stratified squamous epithelium has been replaced by columnar epithelium with goblet cells, without any cytologic atypia.
The presence of a new, fully differentiated adult cell type without malignant features is the defining characteristic of a specific cellular adaptation.
3
Correlate the histologic findings with fundamental definitions of cellular adaptations.
The substitution of one fully differentiated cell type by another is defined as metaplasia.
This confirms the diagnosis of Barrett esophagus, a classic example of metaplasia occurring as an adaptive response to chronic environmental stress.

Anahtar Kavram

Metaplasia is a reversible cellular adaptation where one fully differentiated adult cell type is replaced by another in response to chronic stress or irritation.
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Konular

Cellular Injury and Adaptation

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