Metaplasia vs Dysplasia
How to tell Metaplasia and Dysplasia apart when a board question makes them look alike.
Metaplasia is adaptive mature cell substitution; dysplasia is premalignant atypical disordered growth.
Side by side
Metaplasia is reversible replacement of one mature cell type by another better suited to stress, such as squamous metaplasia in smokers or Barrett esophagus.
Dysplasia is disordered premalignant epithelial growth with atypia, loss of polarity, hyperchromasia, pleomorphism, and increased mitoses.
Stem cells reprogram differentiation in response to chronic irritation or altered environment.
Genetic/epigenetic abnormalities disrupt maturation and architecture, increasing carcinoma risk.
Mature cell-type substitution without severe atypia supports metaplasia.
Atypia, high nuclear-cytoplasmic ratio, disordered maturation, and loss of polarity support dysplasia.
The trap
Both can precede cancer in chronic injury, but atypia and architectural disorder define dysplasia.
Watch it explained
Test it nowThe repair move
For epithelial change, decide whether the cell type switched or the cells became atypical and disordered.
Try a free question
CoreA 58-year-old man with chronic GERD has esophageal biopsy showing replacement of the normal stratified squamous epithelium of the distal esophagus with columnar mucin-producing epithelium and goblet cells (intestinal-type). There is no cytologic atypia. Which process is occurring?
Show answer and explanation
Answer: A. Metaplasia (Barrett esophagus). Barrett esophagus is intestinal-type metaplasia of the distal esophagus replacing normal squamous epithelium with columnar mucin-producing goblet cells in response to chronic acid reflux; surveillance endoscopy is recommended because of risk of progression to dysplasia and adenocarcinoma.
Why the other choices are tempting
- B. Dysplasia would show cytologic atypia (nuclear pleomorphism, hyperchromasia, mitoses).
- C. Carcinoma in situ has full-thickness atypia.
- D. Invasive carcinoma crosses the basement membrane.
- E. Hyperplasia is increased cell number without cell-type substitution.
Flashcards
Tap a card to flip it.
Is metaplasia reversible, and what makes it different from dysplasia?
Metaplasia can be reversible if the stressor is removed and lacks the atypical disordered maturation of dysplasia.
What feature supports dysplasia?
Loss of polarity and cytologic atypia support dysplasia.
Quick answers
What is the fastest way to tell Metaplasia from Dysplasia?
Metaplasia is adaptive mature cell substitution; dysplasia is premalignant atypical disordered growth.
What is the key clue for Metaplasia?
Metaplasia is reversible replacement of one mature cell type by another better suited to stress, such as squamous metaplasia in smokers or Barrett esophagus.
What is the key clue for Dysplasia?
Dysplasia is disordered premalignant epithelial growth with atypia, loss of polarity, hyperchromasia, pleomorphism, and increased mitoses.
What is the common trap with Metaplasia vs Dysplasia?
Both can precede cancer in chronic injury, but atypia and architectural disorder define dysplasia.