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PubMed1989

Mucinous metaplasia to neoplastic lesions in endometrial samples with cytohistologic correlation.

Seven cases of endometrial mucinous metaplasia and five of well-differentiated mucinous adenocarcinoma of the endometrium were studied. Cytologic specimens were obtained by Isaacs endometrial sampler, avoiding endocervical contamination. The histologic diagnosis between the intermediate type of mucinous metaplasia and the well-differentiated mucinous adenocarcinoma posed no problems. DNA analyses of the histologic samples showed a euploid pattern in benign and intermediate types of metaplasia, while well-differentiated mucinous adenocarcinoma showed a hyperdiploid pattern. The cytologic diagnosis of benign mucinous metaplasia should be suggested in the presence of abundant mucinous cells in endometrial samples in the absence of nuclear abnormalities.

Adenocarcinoma, Mucinous↗

PubMed2002

Type III intestinal metaplasia and carcinoma express an identical carbohydrate-epitope revealed by a novel monoclonal antibody (2D11).

A monoclonal antibody (2D11, IgG2b) obtained by immunizing mice with a mucin fraction of the human gastric mucosa reacted specifically to intestinal metaplasia of human gastric mucosa and fetal intestinal mucosa but not to normal adult gastric, small intestinal or colonic mucosa in immunohistochemical staining. The results of Western blotting indicated that 2D11 recognized the high molecular weight glycoprotein(s) (mucin) of the stomach. Treatment of the antigens with sodium periodate abolished their reactivity to 2D11, and digestion of the antigens with beta-galactosidase reduced their reactivity to 2D11. Digestion of the antigens with pronase had no effect, however, suggesting that 2D11 recognizes the oligosugar moiety but not the peptide moiety of the antigens. Further immunohistochemical investigation showed that the reactivity of 2D11 was restricted to the Type IotaIotaIota intestinal metaplasia that is identified by a characteristic staining pattern with the high iron diamine-Alcian blue stain. 2D11 also reacted in high frequency to adenocarcinomas of the stomach (66.7%), pancreas (66.7%) and gallbladder (50.0%), but in low frequency to those in lung (8.3%) and colon (11.1%). It is of interest that 2D11 reacted to very restricted regions of the gastric adenocarcinomas. All monoclonal antibodies to mucin polypeptides (MUC1, 2, 3, 5AC and 6) examined stained intestinal metaplasia and carcinomas in a different pattern from 2D11 in immunohistochemistry. These facts indicate that Type IotaIotaIota intestinal metaplasia and carcinomas express carbohydrate chains identical to those expressed in the fetal intestinal mucosa, suggesting that both of them are closely related to fetal intestinal mucosa.

Animals↗

PubMed1990

Occurrence of intestinal metaplasia of the stomach in Thai patients with gastritis, benign ulcer, and gastric cancer.

Pathological sections of gastrectomized specimens of 74 patients with benign gastric ulcer and 79 with gastric cancer were reviewed. Intestinal metaplasia was found in 26 specimens with benign ulcer (35.1%) and in 43 with cancer (54.4%), a difference that is statistically significant. Further analysis of age groups showed that rate of occurrence of metaplasia in cancer patients older than 60 years was 70.3%, which was significantly higher than that of their younger counterparts (40.5%) and of patients with benign ulcer of either age group. A survey was also conducted by taking biopsies of mucosa of antrum and body of the stomach of 250 patients who underwent gastroscopic examinations. Acute and chronic gastritis was found in 22 and 156 patients, respectively. Intestinal metaplasia was found to be associated with acute gastritis in 2 (9.1%) and with chronic gastritis in 25 (16%) patients. In conclusion, intestinal metaplasia was associated with higher proportion than it was with benign gastric ulcer and gastritis among Thai patients.

Adult↗

PubMed1990

Helicobacter pylori is not identified in areas of gastric metaplasia of gall bladder.

Sections from 200 cholecystectomy specimens were searched microscopically for areas of gastric metaplasia and Helicobacter (Campylobacter) pylori colonization. The presence of gastric metaplasia was confirmed in 31 cases by the presence of tall columnar cells with abundant apical neutral mucin. Examination of haematoxylin and eosin and, in some cases, Warthin-Starry stained sections failed to demonstrate H. pylori in any of these 31 cases or in 29 other cases with 'bladder neck-type mucous gland metaplasia'. The failure of H. pylori to colonize areas of gastric metaplasia in the gall bladder confirms their intolerance to high concentrations of bile.

Adult↗

PubMed1990

Loss of alkaline phosphatase activity in duodenal mucosa: a marker for precursors of gastric metaplasia?

Biopsy specimens from duodenal mucosa in 34 patients with upper gastrointestinal symptoms and endoscopically abnormal mucosa (including duodenitis, active duodenal ulcer, and healed duodenal ulcer) and in 9 patients with histologically normal mucosa were examined histologically for gastric metaplasia and endogenous alkaline phosphatase (AP) activity. Using haematoxylin and eosin (H&E) and periodic acid-Schiff (PAS), we found gastric metaplasia in 91.2 per cent (31 out of 34) of patients with altered duodenal mucosa and in 33.3 per cent (3 out of 9) of patients with histologically normal, non-inflamed duodenal mucosa (P less than 0.001). To characterize gastric metaplasia further, histochemical methods for AP activity were applied to duodenal mucosa specimens. No AP activity was detected in complete metaplastic cells, but focal or diffuse loss of AP activity was frequently shown in otherwise normal appearing enterocytes next to metaplastic cell groups. Focal loss of AP activity was also detected in seven out of nine healthy controls (= 77.8 per cent) which appeared normal when stained with H&E. Our results suggest that the loss of AP activity in enterocytes may be an early marker of developing gastric metaplasia or at least a morphological manifestation of cell damage.

Adult↗

PubMed1987

Intestinal metaplasia of the stomach confined to the fundic gland area. Report of two cases.

Two patients with intestinal metaplasia of the stomach, whose distribution was exclusively confined to the fundic gland area, are presented herein. The first, a 51-year-old male, had been treated for pernicious anemia for 14 years when he was found to have gastric cancer. His serum gastrin level was quite high, whereas his gastric acid output was markedly low. The polypoid cancer in the fornix of the stomach, which had been removed endoscopically, revealed tubular adenocarcinoma with its invasion limited to the mucosa. The resected stomach showed no residual carcinoma but had numerous minute foci of intestinal metaplasia, diffusely distributed but exclusively confined to the fundic gland area, by macroscopic observation using the leucine aminopeptidase-alkaline phosphatase double staining method. The intestinal metaplasias were all of the complete type, and the parietal and chief cells were almost completely lost. The second patient, a 76-year-old male without pernicious anemia, underwent total gastrectomy for two polypoid cancers in the body of the stomach. The resected specimens, in addition to two hyperplastic polyps in the transitional area, showed the same distribution of intestinal metaplasia as seen in the first patient.

Adenocarcinoma↗

PubMed1991

Differences in lectin binding in squamous metaplasia induced by benzo(a)pyrene and vitamin A deficiency in hamster tracheal explants.

Epidermoid metaplasia in the hamster trachea can be produced by treatment with benzo(a)pyrene (BP) or vitamin A deficiency. To elucidate distinguishing features of the two types of lesions, lectin binding to tissue sections of tracheal explants exhibiting metaplastic lesions was assessed. In squamous metaplasia induced by vitamin A deficiency, Dolichos biflorus agglutinin (DBA), wheat germ agglutinin (WGA), and peanut agglutinin (PNA) showed faint (+) to moderate (++) binding in both basal and suprabasal cells; Concanavalin A (Con A) showed moderate binding (++) to suprabasal cells and no binding in basal cells. In the BP-induced lesions, PNA and WGA bound intensely ( +, , respectively) in basal cells and faintly (+) to moderately (++) in suprabasal cells. The staining seemed to be predominant at the periphery of the cells. Further, the intensity of PNA and WGA staining increased significantly after the neuraminidase treatment. DBA and Con A showed faint (+) to moderate (++) binding in the BP-induced metaplasia. The results show that in BP-induced metaplasia, cells in the basal region show preferential binding of PNA and WGA.

Animals↗

PubMed1980

Ultrastructural analysis of the retinoid-induced reversal of epithelial hyperplasia and metaplasia.

The 7, 12-dimethylbenzanthracene-induced skin papilloma of the mouse and the 3-methylcholanthrene-induced hyperplasia and metaplasia in prostate organ cultures were studied by electron microscopy. The two types of tissue both showed a reversal of hyperplasia and metaplasia when treated with retinoids (= vitamin A and analogs). This reversal was reached by means that are quite characteristic for a given type of tissue. In the skin, DNA-synthetic activity was not influenced by retinoid treatment. There was however, considerable necrosis and an impressive mucous metaplasia. The latter might be at least partly responsible for the cell loss, probably through a loss of anchorage in the prickle-cell layer. In the prostate, no mucous metaplasia was observed, but there was an important depression of DNA-synthetic activity. The secretory apparatus reappeared together with the microvilli, possibly induced by the slowing down of cell division.

Animals↗

PubMed1997

Strain differences in the induction of intestinal metaplasia by X-irradiation in rats.

Strain differences in the susceptibility of rats to induction of intestinal metaplasia by X-irradiation were examined. The gastric regions of 5-week-old males of five inbred strains of rats (F344/NSlc, Copenhagen, Buffalo/NacJcl, and ACI/NHos) and three strains of randomly bred rats (HOS:Donryu, Slc:Wistar, Slc:SD) were irradiated with a total dose of 20 Gy X-ray given in two equal fractions at 3-day interrals. When examined after the rats were killed, 6 months after the last irradiation, the number of intestinal metaplastic crypts positive for alkaline phosphatase (ALP) was highest in the Donryu and lowest in the Copenhagen rats. Morphologically, the number of crypts with intestinal metaplasia in the glandular stomachs of Donryu, Wistar, SD, and Buffalo rats was higher than the number in ACI, F344, and Copenhagen rats. Intestinal metaplasia was more frequently observed in the pyloric than in the fundic glands. These results demonstrate that the induction of intestinal metaplasia by X-irradiation in rats is greatly influenced by the rat strain.

Animals↗

PubMed1996

[Mucin histochemical analysis of mucin-forming carcinomas, metaplasias of the urothelium and in persistent urachus].

Twelve cases of mucus secreting metaplasias, nine mucus secreting urothelial carcinomas and three cases of urachus remnants were studied using D-PAS-, m-PAS,- AB pH 2,5/PAS-, HID/AB pH 2,5- and PB/KOH/PAS-technique. Neutral mucins, sialomucins, sulfomucins, O-acylated and unsubstituted or C4- and C7-substituted mucins were detected in different quantities, often intracellular mucus mixtures could be seen. Many differences in the mucus quality of the metaplasias, in comparison to that of the tumors, were not noticeable. Metaplasia associated with carcinoma and mucus secreting carcinomas showed a loss of O-acylated sialomucins and besides diffus positive reaction in m-PAS-technique. Further investigations should confirm if this is really a prognostic factor. O-acylated sialomucins were not only found in metaplastic lesions and urothelial carcinomas but also in metaplasias of the urachus. Therefore it is not possible to distinguish between adenocarcinomas of the urinary bladder and adenocarcinomas derived from the Urachus using PB/KOH/PAS method.

Adenocarcinoma, Mucinous↗

PubMed2006

Anaplastic ependymoma with cartilaginous and osseous metaplasia: report of a rare case and review of literature.

Gliomas with cartilaginous metaplasia are extremely uncommon and thought to be due to metaplasia of the mesenchymal supportive elements. The tumors are located in the midline, mostly fourth ventricle and rarely in the pons. The present paper describes an unusual case of anaplastic ependymoma with cartilaginous and osseous metaplasia in a young boy which was located in the suprasellar, interpeduncular prepontine and left cerebello-pontine cistern. To the best of our knowledge, this cartilaginous metaplasia in ependymomas has been reported only thrice.

Bone Neoplasms↗

PubMed1991

Squamous metaplasia in hormonally treated prostatic cancer. Significance during follow-up.

A prospective study of 59 hormonally treated prostatic cancer cases was undertaken during follow-up with sequential transrectal palpation and fine-needle aspiration. At initiation of therapy patients' ages ranged from forty-eight to eighty-two years (median, 68 years). The usual follow-up interval was 6 +/- 3 months, and follow-up periods ranged from six months to one hundred twenty months (median 48 months). The cytologic findings were categorized under four cytologic response types and palpation findings under five response grades. Four different degrees of squamous metaplasia (1+, 2+, 3+, 4+) were observed in smears, depending on semiquantitative determination of squamous metaplastic cells in relation to the total amount of benign and malignant epithelial cells in the smear. There were 341 follow-up observations in which both transrectal fine-needle aspiration cytology and palpation were done. In 306 of these, cytologic findings were found to be adequate. Comparison of squamous metaplasia with cytologic response types revealed a highly significant difference between the benign state and recurrence/frank malignancy. This was also true when frequency of squamous metaplasia was compared with palpatory response grades. It was found that squamous metaplasia can be a valuable adjunct to other cytomorphologic changes such as shrinkage of tumor cell size and decrease in size of nucleoli or its disappearance, in determining response to hormonal therapy.

Aged↗

PubMed2006

Atypical immature cervical metaplasia: immunoprofiling and longitudinal outcome.

Atypical proliferations of immature cervical squamous metaplasia were reviewed and correlated with p16 and Ki-67 expression to determine whether immunoprofiling could enable more conventional classification. The longitudinal outcome of atypical immature metaplasia (AIM) and predictive role of biomarker expression were also investigated. All atypias of immature squamous metaplasia in the year 2000 were reviewed and stained with p16 and Ki-67. Biomarker features were evaluated and the Ki-67 index calculated. Diagnoses were correlated with the immunoprofile of each antibody, both separately and combined. The progression to squamous intraepithelial lesion (SIL) of lesions reclassified as AIM was determined, and biomarker immunoprofiles were correlated with outcome. The 172 atypias were reviewed as 3 (1.7%) negative, 54 (31.4%) benign, 60 (34.9%) AIM, 43 (25%) low-grade SIL (LSIL), and 12 (6.9%) high-grade SIL (HSIL). HSIL correlated significantly with a combined high index (>15%) and p16 diffusely positive profile (P = .01). Benign diagnoses correlated significantly with a low index (1%-15%) and p16 negative or focal profile (P = .01). AIM and LSIL correlations were not significant, but their profiles were very variable and nearly identical. AIM was the only pathology in 43 cases, and follow-up was available for 32 (74.4%). SIL developed in 66% (50% LSIL and 16% HSIL) and p16 positivity correlated (P = .02). p16 and Ki-67 immunoprofiling are reliable in reclassifying some atypical proliferations of immature squamous metaplasia as HSIL and some as benign. The similarity between AIM and LSIL in regard to their immunoprofile as well as outcome suggests AIM is a morphological type of LSIL.

Biomarkers, Tumor↗

PubMed2006

Identification of lipomatous metaplasia in old infarcted myocardium by cardiovascular magnetic resonance and computed tomography.

Lipomatous metaplasia of myocardium after myocardial infarction (MI) is less reported, and the exact prevalence and clinical implications of this phenomenon are unclear. A case of lipomatous metaplasia after MI evaluated with cardiovascular magnetic resonance (CMR) and computed tomography (CT) is presented. The presence of lipomatous metaplasia could not be easily differentiated from scar simply by the delayed-enhanced images. Loss of signal on TrueFISP cine MRI can be a hint. A pre-contrast T1-weighted image with or without frequency-selective fat suppression is useful in order to verify the existence of lipomatous metaplasia on CMR.

Humans↗

PubMed2006

Chondroid metaplasia in inflamed pulp tissue: a case report.

OBJECTIVE: The aim of the present report is to report an unusual case of chondroid metaplasia of the dental pulp. STUDY DESIGN: A white 45-year-old female patient appeared with signs and symptoms of an irreversible pulpitis on an upper left decayed third molar. After extraction, the tooth was fixed, demineralized, and processed for light microscopy. RESULTS: Pulp tissue was replaced at one of the pulp horns by a colliquative necrosis surrounded by neutrophil leucocytes and congested blood vessels. Serial sections demonstrated a complete opening of the decayed tooth to the oral environment, and an area of chondroid metaplasia of the pulp was evident. Chondroid tissue was surrounded by a dense concentration of chronic inflammation cells. CONCLUSIONS: According to the best knowledge of the authors, this is possibly the first report of an occurrence of chondroid metaplasia in the dental pulp. This metaplasia could be the result of an attempt at tissue repair by the pulp tissue injured by the carious lesion. The pathologic changes in the dental pulp could have activated some of the mechanisms that have been described in other tissues, producing the formation of chondroid tissue. Pulp tissue may adapt to changed environmental stimuli by a deviation from normal cell differentiation.

Cartilage↗

PubMed2005

Stromal osseous metaplasia in a low-grade ovarian adenocarcinoma.

BACKGROUND: Stromal osseous metaplasia is a rare and curious finding in tumors of the ovary. CASE REPORT: The patient, a 66-year-old P3 G3 white female, had a past history of stage 1c left ovarian, well-differentiated endometrioid adenocarcinoma removed in 1981. She was treated with radiotherapy. The tumor recurred 21 years later with prominent stromal osseous metaplasia that had not been present in the primary. DISCUSSION: The pathogenesis of osseous metaplasia in epithelial tumors of the ovary is unclear; however, it is probable that a metaplastic process involving multipotential stromal stem cells results in bone formation. CONCLUSION: Benign osseous metaplasia in ovarian tumors is rare and its histogenesis remains unclear. As far as we know, this process does not appear to have any prognostic or pathological significance.

Aged↗

PubMed2002

Conversion of gastric mucosa to intestinal metaplasia in Cdx2-expressing transgenic mice.

Gastric intestinal metaplasia occurs as a pathological condition in the gastric mucosa. To clarify how an intestine-specific homeobox gene, Cdx2, affects the morphogenesis of gastric mucosa, we generated transgenic mice expressing Cdx2 in parietal cells. Until Day 18 after birth, the number of parietal cells inthegastric mucosa of transgenic mice was the same as for their normal littermates. However, at Day 19, we detected several glands in which parietal cells disappeared and the proliferating zone moved from the isthmus to the base of the glands. Thereafter, parietal cells decreased gradually and disappeared at Day 37. All of the gastric mucosal cells, except for enterochromaffin-like (ECL) cells, were completely replaced by intestinal metaplasia, consisting of goblet cells, enteroendocrine cells, and absorptive cells expressing alkaline phosphatase. Pseudopyloric gland metaplasia was also formed. The transgenic mouse is a very useful model for clarifying physiological differentiation of gastric and intestinal cell lineages and analyzing the molecular events from intestinal metaplasia to adenocarcinoma.

Aging↗

PubMed2004

Cardia-type metaplasia arising in the remnant esophagus after cardia resection.

BACKGROUND: Specialized intestinalized metaplasia in the distal esophagus (Barrett's esophagus) is a recognized precursor of esophageal adenocarcinoma, but its pathogenesis is incompletely understood. The aim of this study was to investigate the mucosal effects of esophagogastrostomy, an artificial interface between esophageal squamous and gastric oxyntic epithelium. METHODS: EGD was performed in 14 consecutive patients (median age 63 years, range 26-71 years) who had undergone esophagogastrostomy from 3 to 88 months earlier. Biopsy specimens were obtained in 13 patients from the anastomosis and, when present, columnar epithelium in the remnant esophagus. RESULTS: In 10 patients, EGD demonstrated tongue-shaped segments of columnar epithelium extending from 0.3 to 7 cm into the remnant esophagus. Biopsy specimens revealed cardia-type mucosa in all patients, whether at the anastomosis or proximally in esophageal segments of columnar epithelium. Magnification endoscopy of cardia-type mucosa visualized a long-oval, tubular, or ridged surface pattern. In 3 cases, complete intestinal metaplasia was observed within the cardia-type mucosa. CONCLUSIONS: The frequent transformation of squamous epithelium into cardia-type mucosa in the distal remnant esophagus after esophagogastrostomy supports the concept that cardia-type mucosa is a reflux-induced metaplasia that may give rise to the subsequent development of specialized intestinalized metaplasia.

Adult↗