FAQ - Metaplasia
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Squamous metaplasia of the bladder. Has anyone been diagnosed with this and what is your treatment?


I had urinary problems last year, had a small patch removed from my bladder and was diagnosed with this condition. I understand what it is and decided not to be overconcerned and just get on with life. I have started with similar symptoms again, but when I ake urine samples to the docs they are often clear of infection or read unspecified. My gp is vague and I am now considering paying private to see a urologist. I would love to speak with someone who has the same diagnosis or has a greater knowledge of this condition. I tend to just put up with symptoms but have got into the achy kidneys feelings again and feel like I am stepping back on a roundabout.
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Squamous metaplasia of the bladder is not a specific diagnosis of anything. It is a histologic diagnosis. (by this i mean the pathologist who looked under the microscope saw this pattern of cell reaction) It is not a single disease that has a specific treatment. Your doctor may have told you the diagnosis to give you a name to your problems, without really explaining what it meant.

Squamous metaplasia happens to many areas of the body in response to almost any kind of physical or chemical irritation.

First think about the skin and what it does. The skin is composed of Squamous epithelium (the outer most layer). The skin is a very effective protective layer, it is hard to get through, it protects against repeated irritation.

The bladder is normally lined with a different type of lining epithelium. When there is something wrong, the body is able to attempt to protect itself by changing the lining to something more resilient. This changing from one type of lining to another is what the word "metaplastic" is referring to. The bladder lining changes to a squamous lining. The bladder will also change back once the irritation goes away. If you were biopsied again at a later date, when you had no symptoms, it probably would have been normal.

Now, unfortunately this does not entirely help you with your current problem. You could have the same problem you had before, or it could be something else. I can not speak to your current situation as to how you get your health care, but if your not satisfied with how you are treated, see someone else. But either way, if your having symptoms, you should see someone.  (+ info)

In the subject of pathology what's the difference between metaplasia and dysplasia?


As title thanks.
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  (+ info)

Poorly differentiated Adenocarcinoma arising in the setting of intestinal Metaplasia with Dysplasia? ?


This is what the biopsy report said for my husband .He has Esophageal Cancer.
I was wondering what this means as this was in my husbands diagnosis for esophageal cancer.
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Poorly differentiated means the cancer cells have little resemblance to a normal cell. It is a system of grading the appearance of the cancer cells. It goes from well differentiated, looking the most normal to undifferentiated, not looking at all like they should. Poorly differentiated is a step above undifferentiated. This is the grade of the cancer and helps determine the prognosis.

Adenocarcinoma is the histological type of cancer your husband has. It is one of the most common types of cancer found in the body.

Metaplasia means the cells formed something that does not normally occur in the tissue in which it is found.

Dysplasia is when cells look abnormal under a microscope but are not cancer. This is sometimes referred to as pre-cancerous.  (+ info)

What is squamous metaplasia? Is it caused by acid reflux? If so is the damage it cuases reversible?


Squamous metaplasia means the change of a tissue's epithelium from it's original state to the squamous type. A good example of this occurs in the bronchi (bronchi). Chronic smoking causes damage to the normal columnar epithelium of the lung. Squamous epithelium, like that found on your skin is designed to deal with damage. This is why you get calluses on your fingers when you play guitar or on your feet when you walk barefoot a lot. In those situations your normal squamous epithelium simply thickens to lessen the damage to the underlying tissues.

Now, back to our discussion on the bronchi. If the columnar epithelium of the bronchi are damaged for a prolonged period it will adapt by switching over to squamous epithelium to better protect itself. This is called squamous metaplasia. The problem with this is that this squamous metaplasia does not secrete mucous like the normal columnar epithelium. This can lead to all kinds of dirt and other things getting down in the lung that shouldn't be there. Also during the and after the process of switching over to from one epithelial type to another the DNA of the cells is very prone to DNA damage and formation of uncontrolled growth or cancer. This makes a prolonged state of metaplasia a risk factor for cancer.

The inside of the espophagus is made of squamous epithelium. Acid reflux can damage the bottom of the esophagus where it joins the stomach. If this occurs it will switch to columnar epithelium. Columna epithelium is normally found in the stomach and intestines and can withstand the acidic contents of the stomach. As above during prolonged metaplasia makes the area prone to cancer formation.

If the damage is removed eventually the metaplasia can reverse back to normal, if there has been no cancer formation.

I think this was a good question. I hope this helps.  (+ info)

What is gastric metaplasia?


My stomach biopsy says I have a prominent gastric metaplasia. What does that mean and does that mean I'm a good candidate for stomach cancer?
My doctor says he wouldn't worry about it. Most people have it and don't know it. He says I don't even have to do GI endoscopy every year. Maybe every 3 to 5 years. But I'm worried about theh word "prominent". I feel like my doctor is trivializing my condition.
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Hello,

I would like to add a few words to the previous answer.

The notion of 'gastric metaplasia' is a bit counter-intuitive. You would think that since 'metaplasia' means, a change of one cell-type to another, that 'gastric metaplasia' would mean a change of the normal 'columnar'-cell inner lining of the stomach, into a different type of cell. But it doesn't.

The normal inside lining of the stomach, is made of up of 'columnar' cells. These look like this, under the microscope, ...http://io.uwinnipeg.ca/~simmons/1115collumnar_epit.jpg ... the characteristic feature of a 'columnar' cell is that it is tall and thin, - or at least 4 times higher than it is wide.

The normal inside lining of the food-pipe or 'esophagus,' is made of 'squamous' cells. These are long flat cells, occurring in sheets, like this, ... http://webanatomy.net/histology/epithelium/simple_squamous.jpg .... pretty much the exact opposite to columnar cells.

The normal 'columnar' epithelium, lining the stomach, is built to withstand acid. The stomach contents are normally very acid, as part of the digestion process. The normal 'squamous' epithelium which lines the food-pipe, is not made to withstand acid, because normally the food-pipe does not hold any acid.

There is a change-point or 'transition point,' where at the lowermost end of the food-pipe, the inside lining type changes from squamous to columnar cells. This is called, in the joined-up technical words, so beloved of doctors, the 'squamo-columnar junction,' more easily also called the 'Z line.' The actual changeover point is about an inch above the stomach, please see this picture... http://www.uptodate.com/patients/content/images/gast_pix/Landmarks_diagnosis_Barrett.jpg

There is a valve at the join between the food-pipe and the upper end of the stomach, to prevent food and drink you've just swallowed into the stomach, from going back up the food-pipe, - - going back where it came from. This valve normally also prevents acid in the stomach, from going back up the food-pipe in the wrong direction.

However, if either there is an awful lot of acid, or the valve is a bit weakened, then acid *can* leak back up into the lower end of the food-pipe. This picture shows that happening,... the acid stomach contents are shown as a yellow color,... http://www.laparoscopy.com/pleatman/images/gerd.jpg

If this happens on a regular basis, the lower squamous epithelium of the food-pipe tries to protect itself by changing into a columnar cell type, like is normal inside the stomach. This is what is called 'gastric metaplasia,' even though it is not happening inside the stomach, but in the lower end of the food-pipe. The lower esophageal inner lining is turning INTO a gastric lining type.

This results in the Z-line, the transition line, moving upwards towards the mouth, and getting fragmented.

This is an inside-view of a lower food-pipe showing the Z-line, where squamous (white) epithelium changes to columnar (deep pink) epithelium... http://www.nature.com/gimo/contents/pt1/thumbs/gimo44-f1.jpg

Here is a good graphic showing the change as the Z-line moves up... leave it on-screen and watch it...
http://i201.photobucket.com/albums/aa276/avatar4u2/barrettsoesophagus.gif

I hope you've followed this!! The other possibility is that the normal inside lining, just beyond the outlet valve of the stomach, (at the bottom end of the stomach), - - can also change into the 'stomach' or 'gastric' cell type,... this is called "gastric metaplasia of the duodenum." Where the duodenum is, is shown here, ... http://www.mydr.com.au/content/images/categories/gastro/stomach_normal.gif

You don't say whether your gastric metaplasia is inside your food-pipe, or inside your duodenum? It will not be inside your stomach, I hope I have explained why.

It's probably of the food-pipe? This condition is also known as "Barrett's esophagus" after the guy who described it.

This abnormally-located stomach-lining (inside the lower esophagus) can definitely be pre-cancerous. The cancer risk is described as low in most patients, see here... http://www.barrettsinfo.com/

The complications (including cancerous change), are well described at this UK Charity Site, of the "Barrett's Foundation," ... http://www.barrettsfoundation.org.uk/probe/managingcomplications/

I think your doctor is trying to reassure you, and I think he is right when he says that a lot of people don't know they've got it. However, I do think it needs taking seriously and I think you should be under the care of a Specialist (if you are not... I am not sure how things work where you are).

The UK Barretts Foundation gives the risk of cancer as 1 in 100 per year, - - 1% a year. They do make the point that the metaplasia usually becomes more serious, (and is then called 'dysplasia'), before actual cancer develops.

I quote their article, << "Once Barrett's oesophagus has been diagnosed and regular acid lowering tablets have been started, a repeat endoscopy and tissue sampling is performed at regular intervals to monitor this condition. This is usually repeated every one to three years, but the exact timing of these checkups depends on each individual case." >> This would be the UK practice.

I hope this is of some help.

Best wishes,

Belliger (retired uk gp)

PS. Interesting, I have done some more research and found that two types of metaplasia *are* cancer precursors in the stomach, - - but they are still named differently (not as "gastric metaplasia"), and according to the same naming convention as above: so the first is called "intestinal metaplasia," - - and is the (metaplastic) appearance of intestinal cell tissue in the stomach; and the second is called "antralization of the fundus," and is the (metaplastic) appearance of specialized enzyme tissue in the top end of the stomach. Neither of these will apply to you!

PPS. Gastric metaplasia in the duodenal bulb, is more often referred to as "heterotopic gastric mucosa" or HGM. It does not appear to have a high malignancy potential, - - indeed some authors consider it protective against duodenal ulcer.  (+ info)

i got my results back and i have an reactive squamous metaplasia and chronic cervicitis.?


is there anyone that is dealing with this right now?
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the metaplasia part is concerning, you should see a gynaecologist soon for further eval and treatment, good luck  (+ info)

whatis the codes for bladder biopsy, chronic cystitis with squamous metaplasia?


If you mean ICD9 codes,

variously, and depending on which code is most appropriate for you

57.34 Open biopsy of bladder

57.33 Closed [transurethral] biopsy of bladder

57.85 Cystourethroplasty and plastic repair of bladder neck
Plication of sphincter of urinary bladder
V-Y plasty of bladder neck

57.39 Other diagnostic procedures on bladder
Excludes:
cystogram NEC (87.77)
microscopic examination of specimen from bladder (91.31-91.39)
retrograde cystourethrogram (87.76)
therapeutic distention of bladder (96.25)


595.2 Other chronic cystitis
Chronic cystitis NOS
Subacute cystitis
Excludes:
trigonitis (595.3)

595.1 Chronic interstitial cystitis
Hunner's ulcer
Panmural fibrosis of bladder
Submucous cystitis

098.31 Gonococcal cystitis, chronic
Any condition classifiable to 098.11, specified as chronic
Gonorrhea of bladder, chronic

595.3 Trigonitis
Follicular cystitis
Trigonitis (acute) (chronic)
Urethrotrigonitis

595.4 Cystitis in diseases classified elsewhere
Code first underlying disease, as:
actinomycosis (039.8)
amebiasis (006.8)
bilharziasis (120.0-120.9)
Echinococcus infestation (122.3, 122.6)
Excludes:
cystitis:
diphtheritic (032.84)
gonococcal (098.11, 098.31)
monilial (112.2)
trichomonal (131.09)
tuberculous (016.1)

582.9 Chronic glomerulonephritis with unspecified pathological lesion in kidney
Glomerulonephritis: specified as chronic
NOS specified as chronic
hemorrhagic specified as chronic
Nephritis specified as chronic
Nephropathy specified as chronic

032.84 Diphtheritic cystitis

595.8 Other specified types of cystitis

595.81 Cystitis cystica

595.9 Cystitis, unspecified  (+ info)

Is metaplasia of the uterus a cancer?


Metaplasia means the tissue is changing to take the form of more characteristic of a tissue some distance away.
Metaplasia is more indicative of endometriosis.
You must have read this on your PAP Smear report. I am sure your gynaecologist will guide you properly. Nothing to be scared of. Just follow your doctor's orders.  (+ info)

Alternative Treatments for Metaplasia?


I've got to give a presentation on Metaplasia as a group tomorrow. My topic to speak about is Alternative Treatment. I'm pretty lost right now.

Does anyone know anything I could say?

Good links?


Thank you,
Ryan
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Metaplasia is indeed a pathological condition. It can be a tissues reaction to an insult as a way to protect itself. This is the case in the lower esophagus when a person has chronic acid reflux the tissues go from a squamous cell to more of a cuboidal or columnar. This condition is known as Barretts esophagus and the next phase from metaplasia is dysplasia and that is cancer. The condition is permanent, so the treatment would be to limit or remove the insult. In this case the alternative treatment would be anything natural to limit or eliminate acid reflux. This can be anything from dietary changes, eating times, sleeping positions, to wearing tight pants. This may be a good theme for you to address since it is extremely common.  (+ info)

LUNGS OF SMOKERS WHY DO THEY REACT TO THE METAPLASIA?


it is an adaptation to their environment ....  (+ info)

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