IPLab:Lab 2:Metaplasia: Difference between revisions - Pathology Education Instructional Resource

(13 intermediate revisions by the same user not shown)

Line 8:

== Images ==

File:~~IPLab2Metaplasia1~~.~~jpg~~|This is a low-power photomicrograph showing the full cortical and medullary thickness of the kidney. Note that there is a dilated calyx containing some red blood cells in the center of the section (arrow). The cortex is markedly thin and has severe lesions of degeneration and atrophy, although these are hard to appreciate at this low magnification.

File:IPLab2Metaplasia1b.JPG| Gross photograph of this kidney with a stone (arrow) in the renal pelvis.

File:~~IPLab2Metaplasia2~~.jpg|This ~~high~~-power photomicrograph demonstrates the transitional epithelium lining the renal calyx (1) and the junction (transition zone) to a thicker hyperplastic epithelium (2). Note the inflammatory cells and increased vascular response in the stromal tissue (3) lying beneath the ~~normal transitional~~ epithelium.

File:IPLab2Metaplasia2b.JPG| This is a low-power photomicrograph showing the full cortical and medullary thickness of the kidney. Note that there is a dilated calyx containing some red blood cells in the center of the section (arrow). The cortex is markedly thin and has severe lesions of degeneration and atrophy, although these are hard to appreciate at this low magnification.

File:~~IPLab2Metaplasia3~~.jpg|A higher-power view shows ~~the junction of~~ normal epithelium (1) with hyperplastic ~~transitional~~ epithelium (2). Note the inflammatory cells in the subepithelial tissue.

File:IPLab2Metaplasia3b.jpg|This higher-power photomicrograph demonstrates the transitional epithelium lining the renal calyx (1) and the junction (transition zone) to a thicker hyperplastic epithelium (2). Note the inflammatory cells and increased vascular response in the stromal tissue (3) lying beneath the epithelium.

File:~~IPLab2Metaplasia4.jpg|This is a higher-power photomicrograph of the junction of normal epithelium (1) with hyperplastic transitional epithelium (2).~~

File:IPLab2Metaplasia4b.jpg|A higher-power view shows more normal epithelium (1) with a transition to hyperplastic and metaplastic epithelium (2). Note the inflammatory cells in the subepithelial tissue.

~~File:IPLab2Metaplasia5~~.jpg|In areas ~~adjacent to~~ the ~~normal transitional~~ epithelium~~, there are areas~~ of epithelium (arrows) ~~where the epithelial cells have the character of normal squamous epithelium~~ as found in the dermis. However, squamous epithelium is not normal in the renal pelvis. This adaptive change is referred to as squamous metaplasia.

File:IPLab2Metaplasia5b.jpg|In some areas the epithelium takes on morphologic characteristics of squamous epithelium (arrows) as found in the dermis. However, squamous epithelium is not normal in the renal pelvis. This adaptive change is referred to as squamous metaplasia.

~~File:IPLab2Metaplasia6.jpg|A high-power photomicrograph of the squamous epithelium shows inflammatory cells in the subepithelial tissue and the formation of keratinized epithelium (arrows).~~

~~File:IPLab2Metaplasia7.jpg|This is a photomicrograph of the trachea from a smoker. Note that the columnar ciliated epithelium has been replaced by squamous epithelium~~.

</gallery>

== Virtual Microscopy ==

=== Kidney: Metaplasia ===

<peir-vm>IPLab2Metaplasia</peir-vm>

=== Normal Kidney ===

<peir-vm>UAB-Histology-00114</peir-vm>

== Study Questions ==

* <spoiler text="What is a neurogenic bladder and what complications may result from this condition?">A neurogenic bladder is any condition or dysfunction of the urinary bladder caused by a lesion of the central or peripheral nervous system. Complications primarily include stasis, infection, and stone formation.</spoiler>

* <spoiler text="What factors in this case predisposed to nephrolithiasis?">Stasis and infection.</spoiler>

* <spoiler text="Does this metaplastic process predispose to neoplasia?">~~Yes~~.</spoiler>

* <spoiler text="Does this metaplastic process predispose to neoplasia?">No.</spoiler>

== Additional Resources ==

Line 35:

Line 37:

=== Journal Articles ===

* ~~Pak CY~~, ~~Sakhaee K~~, ~~Peterson RD~~, ~~Poindexter JR~~, ~~Frawley WH~~. [http://~~www~~.~~ncbi~~.~~nlm~~.~~nih~~.~~gov~~/~~pubmed/11473659 Biochemical profile~~ of ~~idiopathic uric acid nephrolithiasis~~]. ''~~Kidney~~ Int'' ~~2001 Aug;60~~(2):~~757~~-61.

* Barbera M, Fitzgerald RC. [http://www.sciencedirect.com/science/article/pii/S1055320709000180 Cellular Mechanisms of Barrett's Esophagus Development]. ''Surg Oncol Clin N Am '' 2009 18:393–410.

* Spechler SJ and Souza RF. [http://www.nejm.org/doi/full/10.1056/NEJMra1314704 Barrett’s Esophagus]. ''N Engl J Med'' 2014 371:836-45.

* Barbera M, Fitzgerald RC. [http://www.biochemsoctrans.org/content/38/2/370 Cellular origin of Barrett’s metaplasia and oesophageal stem cells]. ''Biochem. Soc. Trans'' 2010 38:370–373.

* Mills JC and Sansom OJ. [http://stke.sciencemag.org/content/8/385/re8.full Reserve stem cells: Differentiated cells reprogram to fuel repair, metaplasia, and neoplasia in the adult gastrointestinal tract]. ''Sci. Signal'' 2015 8(385):re8.

* Clouston B and Lawrentschuk N. [http://onlinelibrary.wiley.com/doi/10.1111/bju.12378/full Metaplastic conditions of the bladder]. ''BJU Int''2013 112(Suppl 2):27-31.

=== Images ===

@@ Line 8: / Line 8: @@
 == Images ==
 <gallery heights="250px" widths="250px">
-File:IPLab2Metaplasia1.jpg|This is a low-power photomicrograph showing the full cortical and medullary thickness of the kidney. Note that there is a dilated calyx containing some red blood cells in the center of the section (arrow). The cortex is markedly thin and has severe lesions of degeneration and atrophy, although these are hard to appreciate at this low magnification.
+File:IPLab2Metaplasia1b.JPG| Gross photograph of this kidney with a stone (arrow) in the renal pelvis.
-File:IPLab2Metaplasia2.jpg|This high-power photomicrograph demonstrates the transitional epithelium lining the renal calyx (1) and the junction (transition zone) to a thicker hyperplastic epithelium (2). Note the inflammatory cells and increased vascular response in the stromal tissue (3) lying beneath the normal transitional epithelium.
+File:IPLab2Metaplasia2b.JPG| This is a low-power photomicrograph showing the full cortical and medullary thickness of the kidney. Note that there is a dilated calyx containing some red blood cells in the center of the section (arrow). The cortex is markedly thin and has severe lesions of degeneration and atrophy, although these are hard to appreciate at this low magnification.
-File:IPLab2Metaplasia3.jpg|A higher-power view shows the junction of normal epithelium (1) with hyperplastic transitional epithelium (2). Note the inflammatory cells in the subepithelial tissue.
+File:IPLab2Metaplasia3b.jpg|This higher-power photomicrograph demonstrates the transitional epithelium lining the renal calyx (1) and the junction (transition zone) to a thicker hyperplastic epithelium (2). Note the inflammatory cells and increased vascular response in the stromal tissue (3) lying beneath the epithelium.
-File:IPLab2Metaplasia4.jpg|This is a higher-power photomicrograph of the junction of normal epithelium (1) with hyperplastic transitional epithelium (2).
+File:IPLab2Metaplasia4b.jpg|A higher-power view shows more normal epithelium (1) with a transition to hyperplastic and metaplastic epithelium (2).  Note the inflammatory cells in the subepithelial tissue.
-File:IPLab2Metaplasia5.jpg|In areas adjacent to the normal transitional epithelium, there are areas of epithelium (arrows) where the epithelial cells have the character of normal squamous epithelium as found in the dermis. However, squamous epithelium is not normal in the renal pelvis. This adaptive change is referred to as squamous metaplasia.
+File:IPLab2Metaplasia5b.jpg|In some areas the epithelium takes on morphologic characteristics of squamous epithelium (arrows) as found in the dermis. However, squamous epithelium is not normal in the renal pelvis. This adaptive change is referred to as squamous metaplasia.
-File:IPLab2Metaplasia6.jpg|A high-power photomicrograph of the squamous epithelium shows inflammatory cells in the subepithelial tissue and the formation of keratinized epithelium (arrows).
-File:IPLab2Metaplasia7.jpg|This is a photomicrograph of the trachea from a smoker. Note that the columnar ciliated epithelium has been replaced by squamous epithelium.
 </gallery>
 == Virtual Microscopy ==
+=== Kidney: Metaplasia ===
 <peir-vm>IPLab2Metaplasia</peir-vm>
+=== Normal Kidney ===
+<peir-vm>UAB-Histology-00114</peir-vm>
 == Study Questions ==
 * <spoiler text="What is a neurogenic bladder and what complications may result from this condition?">A neurogenic bladder is any condition or dysfunction of the urinary bladder caused by a lesion of the central or peripheral nervous system. Complications primarily include stasis, infection, and stone formation.</spoiler>
 * <spoiler text="What factors in this case predisposed to nephrolithiasis?">Stasis and infection.</spoiler>
-* <spoiler text="Does this metaplastic process predispose to neoplasia?">Yes.</spoiler>
+* <spoiler text="Does this metaplastic process predispose to neoplasia?">No.</spoiler>
 == Additional Resources ==
@@ Line 35: / Line 37: @@
 === Journal Articles ===
-* Pak CY, Sakhaee K, Peterson RD, Poindexter JR, Frawley WH.  [http://www.ncbi.nlm.nih.gov/pubmed/11473659 Biochemical profile of idiopathic uric acid nephrolithiasis].  ''Kidney Int'' 2001 Aug;60(2):757-61.
+* Barbera M, Fitzgerald RC.  [http://www.sciencedirect.com/science/article/pii/S1055320709000180 Cellular Mechanisms of Barrett's Esophagus Development].  ''Surg Oncol Clin N Am '' 2009 18:393–410.
+* Spechler SJ and Souza RF.  [http://www.nejm.org/doi/full/10.1056/NEJMra1314704 Barrett’s Esophagus].  ''N Engl J Med'' 2014 371:836-45.
+* Barbera M, Fitzgerald RC.  [http://www.biochemsoctrans.org/content/38/2/370 Cellular origin of Barrett’s metaplasia and oesophageal stem cells].  ''Biochem. Soc. Trans''  2010 38:370–373.
+* Mills JC and Sansom OJ.  [http://stke.sciencemag.org/content/8/385/re8.full Reserve stem cells: Differentiated cells reprogram to fuel repair, metaplasia, and neoplasia in the adult gastrointestinal tract].  ''Sci. Signal'' 2015 8(385):re8.
+* Clouston B and Lawrentschuk N. [http://onlinelibrary.wiley.com/doi/10.1111/bju.12378/full Metaplastic conditions of the bladder]. ''BJU Int''2013 112(Suppl 2):27-31.
 === Images ===