CELLULAR ADAPTATION &

GROWTH DISORDERS
Dr. Sudha Arumugam
 LEARNING OUTCOMES & CONTENTS
CONTENTS DESIRED LEARNING OUTCOMES
• Definition with examples of On completion of the topic, you
different types of cells with should be able to:
regenerative capacity : Labile, • Define and give examples of
Stable & Permanent. different types of cells with
• Adaptation to physiological & regenerative capacity.
pathological stimuli: • Define and describe with
-Hypertrophy, examples, terms related to
-Atrophy adaptation to physiological and
- Hyperplasia pathological stimuli.
- Metaplasia • Definition and examples of
hamartoma & choristoma.
- Dysplasia
• Definition and examples of
Hamartoma and Choristoma.
 What Happens When There Is More
Severe Stress Or Injurious Stimulus?

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 Classes of Tissue
The tissues in our body are divided into three classes according to their
regenerative capacity. How a cell/tissue adapts to the stress depends on
its growth characteristics

Labile Stable Permanent

(continually renewing) (conditionally renewing) (Non-renewing)
e.g. skin, haematopoietic e.g. liver, bone, e.g. neuron, striated &
tissue etc. smooth muscle etc cardiac muscle

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 Adaptations

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HYPERTROPHY
 Hypertrophy
• Increase in size of cells and thus increase in size of
organ or tissue
• Occur in tissue whose cells can not divide-
Striated muscle
•No new cells, just larger cells.
• Not due to cell swelling, but synthesis of more
structural compounds
• Nuclei have higher DNA content, cell arrests
without undergoing mitosis.
Types of hypertrophy
• PHYSIOLOGICAL
– Skeletal muscles ---- weight lifters, athletes
– Hormonal stimulation — Uterus smooth
muscles during pregnancy –oestrogen
• PATHOLOGICAL
– Myocardial hypertrophy — stenotic
(narrowing) valvular diseases or lung diseases
 Pathologic Hypertrophy
Left Ventricular Hypertrophy
in Systemic Hypertension

Gross Microscopy
Gross
Enlarged cardiac myocytes
Normal ventricle thickness Thickened wall of left With enlarged nuclei
ventricle

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Zeus punished Prometheus for stealing light from Gods by chaining him
to a rock in The Caucasus Mountains. Every day, his liver was devoured
by an eagle, only to regenerate overnight.

HYPERPLASIA
 Hyperplasia
• It is the increase in size of an organ due to
increase in number of its constituent cells
• Occur in those organs/ tissues whose cells can
divide
• Hyperplasia after the removal of the stimuli,
does not progress.
Types of hyperplasia
PHYSIOLOGICAL - Increased level of a normal stimulus
(hormonal)
• In regeneration – liver regeneration after injury.
• As a compensatory response, e.g., missing organ in paired
organ, partial resection

PATHOLOGICAL – due to excessive response or excessive

stimulation.
– thyroid gland (goitre) —iodine deficiency.
–– Hormonal Stimulation
– uterine endometrial hyperplasia due to high oestrogen,
– benign prostatic hyperplasia due to androgen stimulation
– Excessive growth factor stimulation by viruses—warts – HPV
 Hyperplasia
Physiologic hyperplasia of
breast during lactation

Hyperplasia of prostate

Endometrial hyperplasia

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 Scenario 3

This kid is from an

area affected by
famine. His parents
were extremely poor
and could not provide
him with adequate
food.

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 Atrophy
• Reduction in size of tissue due to loss of cell substance.
• Physiological – uterus, thyroglossal duct.
• Pathological atrophy –
– Disuse atrophy – decreased workload – muscle
– Denervation atrophy
– Ischaemia – Brain, atherosclerosis.
– Nutrition – Protein energy malnutrition, cachexia.
– Endocrine – breast, endometrium.
– Senile – brain, heart
– Pressure
 Atrophy

Atrophic Testis

Lipofuscin pigment

Brain atrophy in Alzheimer's

Brown Atrophy of heart
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 Scenario 4
This young model used to
advertise for a cigarette
company. To keep up the
image, he smoked about
20 Cigarettes/day. After
5 years, he had persistent
cough. His bronchus
appeared as shown on the
right (below).
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 Metaplasia
• Mature, differentiated (highly specialized)
adult cell type is replaced by another
differentiated cell (less specialized ) type.
• Response to better withstand the adverse
environment
• Prolonged irritation, chronic infection.
Epithelial metaplasia

•In smokers the pseudostratified columnar epithelium

changes to squamous epithelium due to chronic
irritation & inflammation.
• in the lower end of oesophagus, due to acid reflux,
columnar epithelium changes to gastric columnar type
epithelium – barret’s oesophagus.
 Metaplasia
squamous metaplasia

Oesophagus – columnar metaplasia

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 Aplasia/ Agenesis
• Failure of development of tissue or
organ, which is a developmental
abnormality that presumably
develops early in intra uterine life.
• Aplastic organs are either totally
absent or represented by small mass
of fibrous or fatty tissue containing a
few rudimentary cells.
• Paired organs – adrenals, kidneys,
lungs
Unilateral mandibular aplasia
• Aplasia of aorta or pituitary
incompatible with life.
 Hypoplasia
• Failure of organ to attain full
size
• Less severe abnormality than
aplasia.
• Rudimentary organs, smaller
than normal.
• Lack full complement of cells, so
function may be reduced.
 Dysplasia
• Alteration in size, shape and orientation of
epithelial cells with loss of differentiation.
• Is abnormal development of tissue or
disorderly growth.
• The change is considered as preneoplastic.
• Commonly associated with chronic inflammation or
irritation.
• Reversible if irritation is removed, however,
sometimes changes may persist and progress to
malignancy.
Pathology of dysplasia
Microscopically
• Cell atypia and disorderliness
• Loss of uniformity of the individual cells and loss
of architectural orientation
• Cellular atypia is characterized by pleomorphism
and hyperchromasia
• Mitotic figures are seen in abundant cells
Grossly
• No much can be appreciated grossly
Hamartoma vs choristoma
 What are these adaptations?

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 To sum up……..

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THANK YOU!