Adaptive reactions

Hyperplasia, hypertrophy,

metaplasia

Obesity

Dr. Attila Zalatnai

Hyperplasia

Increase of size of organs due to numerical excess of the cells

Response to prolonged stimulus

Organs /tissues that are capable of division

Prerequisite: good blood supply

Causative factors:

- hormonal effects (adrenal cortex, prostate, male breast, acromegaly…)

- prolonged antigenic stimulus (follicular hyperplasia)

- drugs (cyclosporin A – gingival hyperplasia)

- metabolic causes (obesity)

- compensatory

- unknown

Benign prostatic hyperplasia

Hormonal background

Starts around 50 ys, peak incidence: 70-80 years

Accumulation of the perirurethral glands and stroma

Testosterone-production is imperative (not in eunuchs!)

Accumulation of locally produced dihidrotestosterone (DHT)

Major complication: urethral and bladder neck compression, the urine outflow is blocked)

Beningn prostatic hyperplasia

Hypertrophic urinary bladder

Dilatation of the bladder

Hydroureter

Hydronephrosis

Renal insufficiency

Ascensing infections

(pyelonephritis)

Hypertrophy

Increase in size of the organ, but the number of cells is unchanged

Tissue that are non capable of division (muscle)

Characteristically: against increased forces

Increased diameter of te cells, increased DNA content

Striated muscle (physical activity, sports)

Heart muscle

left chamber: hypertension, aortic stenosis

right chamber: increased pulmonary resistance (cor pulmonale chr.)

Congenital pylorus-stenosis

Hypertrophy of the urinary bladder

Hirschsprung-disease

Metaplasia

A mature tissue is replaced by an other mature tissue

Indirect metaplasia (abnormal differentiation of reserve cells)

Epithelial metaplasia:

glandular epithelium squamous epithelium (squamous metaplasia) – bronchus, salivary glands /sialometaplasia/, cervix, pancreas

glandular epithelium another type of glandular epithelium (intestinal metaplasia)

(stomach; esophagus: Barrett-metaplasia; breast: apocrine metaplasia)

Mesenchymal metaplasia:

abnormal differentiation of pluripotent cells (cartilage, bone, etc.)

Increased risk for

Hyperlipidemia

Atherosclerosis

Diabetes mellitus

Arthrosis

Chronic cor pulmonale

Cholelithiasis (6x)

Varicosity

Endometrial cancer, renal cancer

Obesity