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At least 19 recordsLinked to original sources
PubMed1990

Urothelial metaplasia of the bladder mucosa. Nephroid-colonic- and signet-ring cell metaplasia.

Three different types of metaplasia of the urinary bladder are described: nephroid metaplasia, colonic metaplasia and signet-ring cell metaplasia. The latter metaplasia was without any histological signs of malignancy and the patient is still alive without recurrence, 12 years after the diagnosis was made. We believe it is the first published case of benign signet-ring cell metaplasia. The patients with nephroid metaplasia were controlled from 3-18 months without recurrence. Two of the patients with colonic metaplasia were followed from 16 to 132 months; both developed recurrences. In patients with metaplasia of the urothelium, follow-up cystoscopy is recommended because of the recurrent nature of the condition and the malignant potential of metaplastic urothelium.

Aged↗
PubMed1989

[Intestinal metaplasia of the stomach--the significance of single-layer and double-layer metaplasia].

Resected early gastric carcinomas (1,690 cases) and atypical epithelial proliferations (adenomatous lesions, 310 cases) were investigated by the 5 mm-wide step sections. There were two types of intestinal metaplasia; double-layer type, where intestinal metaplasia was in the superficial area with the remaining pyloric or pseudopyloric glands in the deep region of the propria mucosae, and single-layer type, where intestinal metaplasia was usually present in a single layer without remaining deep non-metaplastic glands. These two types of intestinal metaplasia were usually found in the same specimen, however, most of the atypical epithelial proliferations (adenomatous lesions) arose from the area of intestinal metaplasia showing a double-layer type. The mitotic activity was usually found in the transitional zone showing these double-layer intestinal metaplasia. Atypical epithelial cells arose in the transitional zone of the double-layer intestinal metaplasia and spread into the luminal side by budding or replacement of existing epithelial cells. However, the author suspected that the cells in the under area of the transitional zone reproduce non-atypical cells to supplement the cells in the existing pyloric or pseudopyloric glands. On the other hand, atypical epithelial proliferations of single-layer type were rarely found showing a concaved appearance. Some of them may arise from the intestinal metaplasia of single-layer type, where the mitotic region moved towards the lower 1/3 of the glands. It seemed likely that most of the well-differentiated adenocarcinomas arise with intimate relation to these two types of intestinal metaplasia, where the incidence of malignant change of each type has been unknown.

Adenocarcinoma↗
PubMed1980

Distribution of marker enzymes and mucin in intestinal metaplasia in human stomach and relation to complete and incomplete types of intestinal metaplasia to minute gastric carcinomas.

Intestinal metaplasia of the human stomach was classified into two types, complete and incomplete. The complete type was associated with the intestinal marker enzymes sucrose alpha-D-glucohydrolase, alpha, alpha-trehalase, aminopeptidase (microsomal) (APM), and alkaline phosphatase (ALP). Tissue of this type contained goblet cells and Paneth's cells but not high-iron diamine (HID)-positive mucin staining with HID-Alcian blue. The incomplete type of intestinal metaplasia was associated with sucrose alpha-D-glucohydrolase, APM, goblet cells, and HID-positive mucin but not with alpha, alpha-trehalase, ALP, or Paneth's cells. For the examination of the distribution of the complete and incomplete types in 84, 27, and 16 resected specimens of human stomach with gastric carcinoma, gastric ulcer, and duodenal ulcer, respectively, disaccharidases were located with Tes-Tape. Specimens with intestinal metaplasia were divided into three classes: complete type only (class I), incomplete type only (class II), and a mixture of areas of the complete and incomplete types (class III). Of the 84 specimens from patients with gastric carcinoma, intestinal metaplasia was found in 76 (01%), and the percentages of specimens of classes I, II, and III were 32, 22, and 46, respectively. In these specimens, the percent incidence of class I increased and that of class II decreased with age. Of the 27 specimens from patients with gastric ulcer, 16 (59%) shopwed intestinal metaplasia and 10 of the 16 (63%) specimens were of class II. Of the 16 specimens from patients with duodenal ulcer, only 3 (19%) specimens showed intestinal metaplasia and all of them were of class II. The relationships of the complete and incomplete types of intestinal metaplasia to gastric carcinoma wre studied in 26 foci of minute carcinoma of the stomach less than 5 mm in largest diameter. Nineteen of 20 (05%) foci of the intestinal type of minute carcinoma were surrounded by intestinal metaplasia and 16 foci (80%) were surrounded by the incomplete type of intestinal metaplasia.

Adult↗
PubMed1982

Gastric carcinoma and intestinal metaplasia. Significance of types of intestinal metaplasia upon development of gastric carcinoma.

For clarifying significance of subtypes of intestinal metaplasia upon the development of stomach carcinoma, 34 stomachs surgically removed for mucosal carcinoma were morphologically studied. Intestinal metaplasia was divided into incomplete and complete types by alcian blue-PAS staining. The incomplete type has been understood as an immature stage of the development of the metaplasia as previously reported by us. In this, study, it was revealed that the incomplete type of metaplasia showed more dysplastic features than the complete type. Analysis of the metaplasia of the gastric mucosa surrounding cancer tissue revealed that well differentiated adenocarcinoma frequently came into contact with the incomplete type of metaplasia in small cancer, less than 1 cm. This relationship became less evident as carcinoma became larger. In poorly differentiated carcinoma, however, any correlations between types of metaplasia and size of cancer were not demonstrated. From these results, it was suggested that well differentiated adenocarcinoma arises from the incomplete type of metaplasia.

Carcinoma↗
PubMed1984

A study of incidence and relationship of intestinal metaplasia of gastric antrum and gastric metaplasia of duodenum in patients with nonulcer dyspepsia.

The incidence and relationship of intestinal metaplasia of the gastric antrum and gastric metaplasia of the first part of the duodenum were studied in endoscopic biopsies from 120 patients with nonulcer dyspepsia. Intestinal metaplasia was present in 29% of antral biopsies and gastric metaplasia in 39% of duodenal biopsies, with 9% of patients having both. Intestinal metaplasia was not related to alcohol consumption, but was significantly higher in patients who smoked 10 cigarettes or more daily. (P less than 0.002). Gastric metaplasia was associated with duodenitis. Its incidence was significantly higher in males (P less than 0.001) and in patients with a history of high/moderate alcohol intake (P less than 0.02); these findings are reminiscent of the presence of a similar relationship between these factors and duodenal ulcers and support the suggestion that duodenitis and duodenal ulcers probably represent different parts of a single disease spectrum. The presence of both types of metaplasia in 9% of the patients suggest that factors other than gastric acidity may influence the development of metaplasia.

Alcohol Drinking↗
PubMed1996

Endoscopic and histological appearance of pancreatic metaplasia in the human gastric mucosa: a preliminary report on a recently recognized new type of gastric mucosal metaplasia.

Recently a new type of gastric mucosal metaplasia referred to as pancreatic metaplasia (pancreatic acinar metaplasia) has been recognized. The difference is characterized by the presence of epithelial cells with the cytoplasm strongly basophilic in the basal compartment, whereas in the middle and apical portions it is acidophilic and finely granular. In contrast to intramuscular heterotopic pancreas, foci of pancreatic metaplasia are located in the lamina propria of the gastric mucosa. They form lobules, small clusters, or may be single. The present series included 13 cases of pancreatic metaplasia found in gastroscopic specimens obtained from seven women and six men. We investigated the histological pattern and endoscopic changes. Based upon clinical data it was found that in five patients the gastric mucosa was defined as 'dichromatic'. It is possible that studies involving greater numbers of patients will permit closer correlation between the histological pattern of pancreatic metaplasia and the corresponding endoscopic changes.

Adult↗
PubMed1987

Histopathogenesis of intestinal metaplasia: minute lesions of intestinal metaplasia in ulcerated stomachs.

Minute lesions of intestinal metaplasia composed of a few metaplastic tubules were observed in the gastric mucosa during routine histological examination of gastrectomy specimens. The histological findings indicated that these lesions might be an initial stage of more advanced intestinal metaplasia. Accordingly, more than 18,000 serial sections in 10 stomachs with chronic ulcers were examined to clarify the histopathogenesis of the intestinal metaplasia. It was concluded from the three dimensional reconstruction of minute intestinal metaplasia lesions that these lesions originated during the regenerative process of healing of gastric erosions. The lesions were roughly globoid with a depression on the surface. It is thought that with continuous formation and healing of gastric erosions, more extensive intestinal metaplasia lesions would be formed by an increase in size and confluence of these focal minute intestinal metaplasia lesions.

Duodenal Ulcer↗
PubMed1984

Are metaplasias in colorectal adenomas truly metaplasias?

Five thousand seven hundred seventy-eight adenomas or adenomas containing carcinoma from 3215 patients were examined by routine histologic methods for the presence of epithelial metaplasias. Three forms of epithelial metaplasia were encountered: squamous cell metaplasia (0.44%), Paneth cell metaplasia (0.20%), and melanocytic metaplasia (0.017%). In several instances multiple forms of metaplasia were encountered in the same polyp. In those cases in which the paraffin blocks were available, a Grimelius stain was performed. Grimelius-positive cells were present in 63% of the adenomas containing a metaplastic cell type. All cases with Paneth cell differentiation were immunoreactive for lysozyme; all lesions containing areas of squamous differentiation were immunoreactive for keratin except 2. The histopathologic features of these cases are discussed, and it is concluded that rather than representing a true metaplastic process, Paneth cell, squamous cell, and melanocyte differentiation represent the full range of cellular differentiation that endodermally derived tissues can exhibit, particularly when they undergo neoplastic alterations.

Adenoma↗
PubMed1997

A new aspect of gastric metaplasia in Crohn's disease: bidirectional (foveolar and pyloric) differentiation in so-called 'pyloric metaplasia' in the ileum.

Mucus-secreting cells found at the site of ileac ulceration in Crohn's disease have been described as 'pyloric metaplasia'. Using mucin-histochemical methods and immunohistochemical stainings for Ki-67 antigen and foveolar-type mucin (M1) of the stomach, the characteristics of this type of metaplasia were studied in surgically resected ileac specimens from two Japanese patients with Crohn's disease. Not only pyloric-type cells but also foveolar-type cells were demonstrated; often displaying an organoid growth of the normal stomach mucosa. Stem cells of the ileac crypt may differentiate potentially to intestinal-, pyloric- and also to foveolar-type cells. The term 'pyloric metaplasia' is not appropriate and 'gastric metaplasia' should be used when describing this type of metaplasia.

Adult↗
PubMed2003

Synthesis and localization of pancreatic secretory proteins in pancreatic acinar-like metaplasia in the distal part of the oesophagus. Pancreatic acinar metaplasia: another source of pancreatic enzymes!

BACKGROUND: Pancreatic acinar-like metaplasia has previously been described in the gastric mucosa and in the distal part of the oesophagus. The resemblance to pancreatic acinar cells prompted us to study the possible occurrence of secretory pancreatic proteins in these cells. METHODS: Seven specimens obtained from the distal oesophagus at gastroscopy where routine microscopy showed pancreatic acinar-like metaplasia were selected for this study. Sections were subjected to immunohistochemical detection of trypsinogen, pancreatic elastase, procarboxypeptidase B and pancreatic secretory trypsin inhibitor using specific antisera. An alkaline-phosphatase-conjugated oligodeoxynucleotide probe, complementary to the transcript for trypsinogen 2 (anionic) was used for in situ hybridization. RESULTS: Cells with pancreatic acinar-like metaplasia were immunoreactive to all pancreatic secretory proteins studied. In situ hybridization showed the presence of trypsinogen 2 mRNA in pancreatic acinar-like metaplasia. The pancreatic proteins were not seen in other cells in the distal oesophagus. CONCLUSION: Pancreatic acinar-like metaplasia is common in the distal oesophagus and pancreatic secretory proteins, including trypsininogen 2, are produced in the oesophageal metaplastic acinar cells. The biological significance of this finding has yet not been thoroughly studied.

Adolescent↗
PubMed1993

The expression of the trefoil peptides pS2 and human spasmolytic polypeptide (hSP) in 'gastric metaplasia' of the proximal duodenum: implications for the nature of 'gastric metaplasia'.

Expression of pS2 protein (an oestrogen-induced gene discovered in the MCF-7 breast carcinoma cell line) and its homologue human spasmolytic polypeptide (hSP) was analysed, using immunohistochemistry and in situ hybridization to their mRNAs, in the proximal duodenum of 17 partial gastrectomy specimens removed from individuals with chronic peptic ulceration. Eight were found to have gastric-type metaplasia. In gastric metaplasia, mRNAs for pS2 and hSP, and pS2 peptide antibody were co-localized in the cells covering the duodenal villi. pS2 immunostaining was diffusely cytoplasmic in nature. A similar pattern was seen in Brunner's gland ducts. The trefoil peptide localization in gastric metaplasia closely resembles that seen in superficial gastric epithelium and the distal Brunner's gland duct, which in turn shares morphological similarities with gastric epithelium. We therefore conclude that gastric metaplasia may be the result of an expansion of the surface component of the Brunner's gland duct. The function of these trefoil peptides is at present unknown, but their distribution elsewhere suggests an involvement in reparative mechanisms. The similarities between gastric foveolar and Brunner's gland duct epithelium may derive from common restitution-enhancing features pertinent to a locally harsh environment.

Brunner Glands↗
PubMed2000

Comparison of clinical, endoscopic and functional findings in patients with intestinal metaplasia at the cardia, carditis and short-segment columnar epithelium of the distal esophagus with and without intestinal metaplasia.

In recent years, the diagnosis of short segments of intestinal metaplasia lining the distal esophagus has increased. The aim of the present study was to determine the clinical, endoscopic, histologic and functional results in patients with intestinal metaplasia at the cardia (IMC), carditis and short-segment columnar epithelium (CE) lining the distal esophagus with and without intestinal metaplasia. Four groups were studied: 48 patients with carditis, 105 patients with IMC, 78 patients with short-segment CE (SSCE) without IM and 69 patients with short-segment CE with IM. All had clinical questionnaire, endoscopic and histological evaluation, manometric studies and measurements of acid and bilirubin exposition of the distal esophagus over 24 h. Patients without IM were found to be younger than those with IM. Erosive esophagitis was observed in similar proportions, but hiatal hernia was present in patients with SSCE with or without IM. Patients without IM had mainly cardial mucosa more than fundic mucosa. However, patients with IM had almost exclusively cardial mucosa. Low-grade dysplasia was observed only in patients with IM. Manometric evaluation demonstrated a structural defective lower esophageal sphincter in all groups. Acid and duodenal exposures of the distal esophagus over 24 h were significantly greater in patients with SSCE with IM. In the presence of pathologic gastroesophageal reflux (GER), there are several histological changes at the mucosa distal to the squamous columnar junction. The first metaplastic change is one from fundic to cardial mucosa and, when duodenal reflux occurs, a second metaplastic change to intestinal metaplasia from cardial mucosa occurs. Therefore, in all patients with symptoms of GER, biopsies specimens distal to the squamous columnar junction should be taken routinely.

Cardia↗
PubMed1980

Argentaffin cells, intestinal metaplasia and antral metaplasia in carcinoma of the gall bladder.

The occurrence of argentaffin cells, intestinal metaplasia, and antral metaplasia has been studied in 20 gall bladders with carcinomas, in a papilloma, and in 20 specimens of cholelithiasis. Argentaffin cells were present in six carcinomas, but in only one specimen were they present in large numbers. Only one adenocarcinoma contained occasional argyrophil cells and no argentaffin or argyrophil cells were seen in the papilloma. Five of the 20 specimens of cholelithiasis contained occasional argentaffin cells. Intestinal and antral metaplasia were found in four carcinomas, in the papilloma, and in seven of the 20 specimens of cholelithiasis. It is suggested that metaplastic changes may play a role in the pathogenesis of carcinoma of the gall bladder.

Carcinoma in Situ↗
PubMed1986

[Histopathogenesis of intestinal metaplasia--minute lesions of intestinal metaplasia in the ulcer-bearing stomach].

More than 18,000 serial sections were performed in 10 ulcer-bearing gastrectomy specimens with mild intestinal metaplasia and containing minute lesions of intestinal metaplasia composed of a few metaplastic tubules, which often had an onion skin-like appearance. Fifty-two minute lesions could be reconstructed and examined three-dimensionally in these serial sections. As a result of this study, these minute lesions showed, without exception, a very close resemblance to a hen's egg or globe and had a dimple at the center. Moreover, we could detect minute lesions of intestinal metaplasia in which erosion and indifferent epithelia coexisted. From the various circumstantial findings, it was demonstrated that these lesions originated in the regenerative process of erosions.

Duodenal Ulcer↗
PubMed1995

Helicobacter pylori in patients with intestinal metaplasia and in controls: a serological and biopsy study in four UK centres. UK Sub-Group of the ECP-EURONUT-Intestinal Metaplasia Study Group.

The incidence of Helicobacter pylori was compared in high and low risk gastric cancer areas. Complete data were available on 116 age and sex matched sets of cases--patients with histologically proven intestinal metaplasia (IM)--and two control groups, one non-IM endoscoped controls (EC) and one non-endoscoped controls (NC) recruited from out-patient clinics. H. pylori status was determined by both serology and histology in individuals biopsied from three separate gastric sites. Our data show an increased incidence of H. pylori and intestinal metaplasia in areas at high risk for gastric cancer, good agreement on H. pylori status between histology and serology and a relationship between H. pylori status in individual biopsies and the degree of gastritis. With 116 matched sets of patients this is one of the largest series to date and supports the hypothesis that H. pylori infection may be involved in gastric carcinogenesis through chronic gastritis and intestinal metaplasia.

Adult↗
PubMedDate not supplied

Myeloid metaplasia of the central nervous system in patients with myelofibrosis and agnogenic myeloid metaplasia. Report of 3 cases and review of the literature.

Foci of meningeal myeloid metaplasia were found in 3 of 11 consecutive autopsied patients with myelofibrosis and agnogenic myeloid metaplasia. The clinical and pathological findings in an additional seven published patients with agnogenic myeloid metaplasia who developed neurological manifestations due to pressue of hemopoietic tumors in the central nervous system are reviewed.

Aged↗
PubMed2001

Papillary immature metaplasia of the uterine cervix: a report of 5 cases with an emphasis on the differential diagnosis from reactive squamous metaplasia, high-grade squamous intraepithelial lesion and papillary squamous cell carcinoma.

Papillary immature metaplasia (PIM) is a distinctive exophytic lesion of the uterine cervix and shares some histologic and cytologic features with ordinary squamous metaplasia (SM), atypical immature squamous metaplasia (AIM), high-grade squamous intraepithelial neoplasia (HSIL) and papillary squamous cell carcinoma (PSC). PIM has been suggested to be a subset of condyloma associated with low-risk type human papilloma virus (HPV), however, the etiologic role of HPV and biologic behavior of the disease are still elusive. We compared the clinical and histopathological findings, immunohistochemical expression of Ki-67 and p53 protein, and HPV typing of 5 cases of PIM with SM (n=9), HSIL (n=6), and PSC (n=4) to know the helpful features for the differential diagnosis. Histologically, all 5 cases showed a papillary proliferation of immature metaplastic cells involving the proximal transformation zone and endocervix. On HPV typing by polymerase chain reaction-restriction fragment length polymorphism, 2 out of 5 PIM were confirmed to have HPV 6 or HPV 11, while 2 out of 4 PSC were proved having HPV 31 and HPV 16 each. Ki-67 labeling index and mitotic index of PIM were significantly lower than those of HSIL or PSC. There were no significant differences of Ki-67 labeling index and mitotic index between PIM and SM. The expression of p53 varied among the groups and thus it was not helpful for the differential diagnosis.

Adult↗
PubMed1993

Apocrine metaplasia: a new type of müllerian metaplasia.

Apocrine differentiation was an incidental finding in an ovarian cyst. This is considered to be a further example of Müllerian metaplasia that has not been described before and which, theoretically, could occur in any organ of Müllerian derivation (ovary, uterus, cervix or fallopian tube). It is suggested that sites of such metaplasia could in turn be the origin of primary apocrine carcinoma in any of the above locations.

Apocrine Glands↗