A 48-year-old man with chronic reflux symptoms undergoes biopsy of the distal esophagus. Squamous epithelium is replaced by intestinal-type columnar epithelium with goblet cells. This change is best classified as:
- A Hyperplasia, due to increased cell number from growth factor stimulation
- B Dysplasia, a premalignant disorderly proliferation
- C Metaplasia, a reversible replacement of one adult cell type by another better able to withstand stress ✓
- D Hypertrophy, due to increased cell size without new cell types
Correct answer: C. Metaplasia, a reversible replacement of one adult cell type by another better able to withstand stress
Explanation
Barrett esophagus is the classic example of metaplasia: chronic acid exposure causes squamous epithelium to be replaced by intestinal-type columnar epithelium, a cell type more resistant to acid but associated with later adenocarcinoma risk. Hyperplasia increases the number of cells of the same type, hypertrophy increases cell size, and dysplasia implies disordered architecture and cytologic atypia that are not required for this diagnosis. Metaplasia is reversible if the inciting stress is removed.
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.