A 52-year-old man with long-standing GERD undergoes upper endoscopy. Biopsy of the distal esophagus shows replacement of stratified squamous epithelium by intestinal-type columnar epithelium with goblet cells. This change is best classified as:
- A Metaplasia ✓
- B Hypertrophy
- C Hyperplasia
- D Dysplasia
Correct answer: A. Metaplasia
Explanation
Metaplasia is the reversible replacement of one differentiated cell type by another better able to withstand the adverse environment. Chronic acid exposure induces squamous-to-columnar intestinal metaplasia (Barrett esophagus). Hyperplasia and hypertrophy increase cell number and size respectively without changing cell type. Dysplasia denotes disordered growth with cytologic atypia, which may arise later within Barrett mucosa but is not what the described epithelial substitution represents. Metaplasia here carries malignant risk via progression to adenocarcinoma.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.