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Dysplasia

Dysplasia (latin for 'bad form') is an abnormality in the appearance of cells indicative of an early step towards transformation into a neoplasia. It is therefore a pre-neoplastic or pre-cancerous change. This abnormal growth is restricted to the epithelial layer, not invading into the deeper tissue. Though dysplasia may regress spontaneously, persistent lesions must be removed, either with surgery, chemical burning, heat burning, burning with laser, or freezing (cryotherapy). more...

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The best know form of dysplasia is the precursor lesions to cervical cancer, called cervical intraepithelial neoplasia (CIN). This lesion is caused by an infection with the human papilloma virus (HPV). Dysplasia of the cervix is almost always unsuspected by the woman. It is usually discovered by a screening test, the pap smear. The purpose of this test is to diagnose the disease early, while it is still in the dysplasia phase and easy to cure.

Dysplasia vs carcinoma in situ vs invasive carcinoma

These terms are related since they represent the three steps of the progression towards cancer:

  • Dysplasia is the earliest form of pre-cancerous lesion recognizable in a biopsy by a pathologist. Dysplasia can be low grade or high grade (see CIS below). The risk of low grade dysplasia transforming into high grade dysplasia and, eventually, cancer is low. Treatment is usually easy.
  • Carcinoma in situ is synonymous with high grade dysplasia in most organs. The risk of transforming into cancer is high. Treatment is still usually easy.
  • Invasive carcinoma, commonly called cancer, is the final step in this sequence. It is a disease who, when left untreated, will invade the host (hence its name) and will probably kill him. It can be often, but not always, be treated successfully.

Metaplasia is a situation where cells have changed from their original mature differentiated type into another mature differentiated cell type as an adaptive response to exposure to chronic irritation, or to a pathogen or carcinogen. It also occurs where one normal cell type changes into another normal cell type as in the cervix where squamous epithelium on the exo-cervix changes to normal columnar epithelium in the endo-cervix. This area is also known as the transformation zone and is the location of many dyplastic lesions thus the sampling of this area during a pap test is critical. Metaplasia is distinct from dysplasia because in a dysplastic cell these changes have become encoded into the genome and so are heritable or passed on to daughter cells during cell replication.

Read more at Wikipedia.org


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Intracerebral abscess secondary to frontal mucocele with underlying fibrous dysplasia
From Ear, Nose & Throat Journal, 4/1/04 by Enrique Palacios

Intracranial meningitis and intracerebral abscesses secondary to frontal sinus diseases, such as sinusitis and mucoceles, are well known? Frontal sinus mucoceles are usually the result of an inflammatory obstruction of the ostium. (2) However, other causes of frontal sinus obstruction can be identified, such as a frontal sinus osteoma, a post-traumatic sinus lesion, and occasionally obstruction by a fibro-osseous lesion, such as a fibrous dysplasia. (2,3)

In the case illustrated here, an intracranial complication from a frontal sinus mucocele with cerebral abscess was identified in a 45-year-old man who had complained of headaches, obtundation, and fever. The obstruction of the frontal sinus proved to be a localized fibrous dysplasia. Fibrous dysplasia represents a benign idiopathic bone disorder in which cancellous bone is replaced by abnormal fibrous tissue. (3) A frontal sinus mucocele is a rare complication of craniofacial fibrous dysplasia, as was demonstrated in this case by computed tomography (CT) (figure 1) and magnetic resonance imaging (MRI) (figure 2).

[FIGURES 1-2 OMITTED]

References

(1.) Harnsberger HR. Sinonasal imaging: Imaging issues in sinusitis. In: Harnsberger HR. Handbook of Head and Neck Imaging. 2nd ed. St. Louis: Mosby, 1995:339-95.

(2.) Som PM, Brandwein MS. Inflammatory diseases. In: Som PM, Curtin HD, eds. Head and Neck Imaging. 4th ed. St, Louis: Mosby, 2003:193-259.

(3.) Atasoy C, Ustuner E, Erden I, Akyar S. Frontal sinus mucocele: A rare complication of craniofacial fibrous dysplasia. Clin Imaging 2001;25:388-91.

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