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ADAPTIVE DISORDERS, ATROPHY, HYPERTROPHY, HYPERPLASIA, METAPLASIA,…

- - - - changes in size and number
        
        (hypertrophy, atrophy, hyperplasia),
      - changes in pathway of phenotypic differentiation
        
        (metaplasia, dysplasia)
      - Adaptive responses are reversible on withdrawal of stimulus
        
        Prolonged stimulus can lead to cell death
        
        •‘survival of the adaptable’
- - - - starvation,
        
        ischaemic
        
        disuse atrophy
        
        (wasting of muscles in cast),
        
        neuropathic atrophy
        
        (poliomyelitis, motor neuron disease),
        
        endocrine atrophy
        
        (hypopituitarism leads to thyroid,
        adrenal, gonadal atrophy),
        
        pressure atrophy
        
        2 more items...
        
        (atrophic kidneys, brain in atherosclerosis),
- - - - Pathologic:
        
        cardiac muscle
        
        systemic HTN,
        
        Aortic valve disease,
        
        Mitral Insufficiency
        
        Smooth muscle
        
        pyloric stenosis
        
        muscular arteries in HTN
        
        skeletal muscle
        
        in athletes, labourers
        
        compensatory hypertrophy
        
        when contralateral organ removed
        such as kidney, adrenal gland
- - - - Different from neoplasia (lack of growth regulatory mechanism)
        
        Physiological:
        
        hormone hyperplasia
        (female breast in puberty, pregnancy,
        lactation, uterine hyperplasia in pregnancy, endometrial proliferation in normal menstrual cycle, BPH,
        
        compensatory hyperplasia (liver following
        hepatectomy, epidermis after skin abrasion)
        
        Pathologic:
        
        endometrial hyperplasia in estrogen excess,
        
        skin warts due to Human papilloma virus,
        
        intraductal epithelial hyperplasia in
        fibrocystic change in breast
- - - - Squamous :
        bronchus in chronic smokers,
        uterine endoervix in prolapse of uterus, gallbladder in chronic cholecystitis with cholelithiasis, prostate in chronic prostatitis, renal pelvis and urinary bladder in chronic
        infection, Vit A deficiency.
      - Columnar: intestinal metaplasia in chronic gastric ulcer, Barrette’s oesophagus
        (normal squamous to columnar),
        cervical erosion
      - Mesenchymal: less often
        
        Osseous:
        formation of bone in arterial wall in old age, cartilage of larynx and bronchi, scar of chronic
        inflammation
        
        Cartilaginous:
        healing of fractures
- - - - Dysplasia may progress into
        carcinoma in situ or invasive cancer
        
        table