Hyperplasia

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Hyperplasia
Hyperplasia vs Hypertrophy.svg
Whereas hypertrophy stems from an increase in cell size, hyperplasia results from an increase in cell number.
Specialty Pathology
TypesBenign prostatic hyperplasia, Hyperplasia of the breast(many more) [1] [2]
Diagnostic method Biopsy [3]
TreatmentDepends which type (see types)

Hyperplasia (from ancient Greek ὑπέρ huper 'over' + πλάσις plasis 'formation'), or hypergenesis, is an enlargement of an organ or tissue caused by an increase in the amount of organic tissue that results from cell proliferation. [4] It may lead to the gross enlargement of an organ, and the term is sometimes confused with benign neoplasia or benign tumor. [5]

Contents

Hyperplasia is a common preneoplastic response to stimulus. [6] Microscopically, cells resemble normal cells but are increased in numbers. Sometimes cells may also be increased in size (hypertrophy). [7] Hyperplasia is different from hypertrophy in that the adaptive cell change in hypertrophy is an increase in the size of cells, whereas hyperplasia involves an increase in the number of cells. [8]

-plasia and -trophy
  • Abiotrophy (loss in vitality of organ or tissue)
  • Atrophy (reduced functionality of an organ, with decrease in the number or volume of cells)
  • Hypertrophy (increase in the volume of cells or tissues)
  • Hypotrophy (decrease in the volume of cells or tissues)
  • Dystrophy (any degenerative disorder resulting from improper or faulty nutrition)

Causes

Hyperplasia may be due to any number of causes, including proliferation of basal layer of epidermis to compensate skin loss, chronic inflammatory response, hormonal dysfunctions, or compensation for damage or disease elsewhere. [9] Hyperplasia may be harmless and occur on a particular tissue. An example of a normal hyperplastic response would be the growth and multiplication of milk-secreting glandular cells in the breast as a response to pregnancy, thus preparing for future breast feeding. [10]

Perhaps the most interesting and potent[ editorializing ] effect insulin-like growth factor 1 (IGF) has on the human body is its ability to cause hyperplasia, which is an actual splitting of cells. [11] By contrast, hypertrophy is what occurs, for example, to skeletal muscle cells during weight training and is simply an increase in the size of the cells. [12] With IGF use, one is able to cause hyperplasia which actually increases the number of muscle cells present in the tissue. [13] Weight training enables these new cells to mature in size and strength. It is theorized that hyperplasia may also be induced through specific power output training for athletic performance, thus increasing the number of muscle fibers instead of increasing the size of a single fiber. [14]

Mechanism

Hyperplasia is considered to be a physiological (normal) response to a specific stimulus, and the cells of a hyperplastic growth remain subject to normal regulatory control mechanisms. [5] However, hyperplasia can also occur as a pathological response, if an excess of hormone or growth factor is responsible for the stimuli. Similarly to physiological hyperplasia, cells that undergo pathologic hyperplasia are controlled by growth hormones, and cease to proliferate if such stimuli are removed. [15] This differs from neoplasia (the process underlying cancer and benign tumors), in which genetically abnormal cells manage to proliferate in a non-physiological manner which is unresponsive to normal stimuli. [16] That being said, the effects caused by pathologic hyperplasia can provide a suitable foundation from which neoplastic cells may develop. [15]

Role in disease

Hyperplasia of certain tissues may cause disease. Pathologic hyperplasia in these tissues may occur due to infection, physiological stress or trauma, or abnormal levels of particular hormones, such as estrogen, ACTH, or cortisol. [17]

Types

Some of the more commonly known clinical forms of hyperplasia, or conditions leading to hyperplasia, include:

Patient with hemihyperplasia involving the upper and lower left extremities. The leg length discrepancy can be noted by the pelvic tilt. Hemihyper.jpg
Patient with hemihyperplasia involving the upper and lower left extremities. The leg length discrepancy can be noted by the pelvic tilt.

See also

Related Research Articles

<span class="mw-page-title-main">Adrenal gland</span> Endocrine gland

The adrenal glands are endocrine glands that produce a variety of hormones including adrenaline and the steroids aldosterone and cortisol. They are found above the kidneys. Each gland has an outer cortex which produces steroid hormones and an inner medulla. The adrenal cortex itself is divided into three main zones: the zona glomerulosa, the zona fasciculata and the zona reticularis.

<span class="mw-page-title-main">Endocrine system</span> Hormone-producing glands of a body

The endocrine system is a messenger system in an organism comprising feedback loops of hormones that are released by internal glands directly into the circulatory system and that target and regulate distant organs. In vertebrates, the hypothalamus is the neural control center for all endocrine systems.

<span class="mw-page-title-main">Human body</span> Entire structure of a human being

The human body is the entire structure of a human being. It is composed of many different types of cells that together create tissues and subsequently organs and then organ systems. They ensure homeostasis and the viability of the human body.

<span class="mw-page-title-main">Prostate</span> Gland of the male reproductive system in most mammals

The prostate is both an accessory gland of the male reproductive system and a muscle-driven mechanical switch between urination and ejaculation. It is found in all male mammals. It differs between species anatomically, chemically, and physiologically. Anatomically, the prostate is found below the bladder, with the urethra passing through it. It is described in gross anatomy as consisting of lobes and in microanatomy by zone. It is surrounded by an elastic, fibromuscular capsule and contains glandular tissue, as well as connective tissue.

<span class="mw-page-title-main">Anterior pituitary</span> Anterior lobe of the pituitary gland

A major organ of the endocrine system, the anterior pituitary is the glandular, anterior lobe that together with the posterior lobe makes up the pituitary gland (hypophysis) which, in humans, is located at the base of the brain, protruding off the bottom of the hypothalamus.

<span class="mw-page-title-main">Adenoma</span> Type of benign tumor

An adenoma is a benign tumor of epithelial tissue with glandular origin, glandular characteristics, or both. Adenomas can grow from many glandular organs, including the adrenal glands, pituitary gland, thyroid, prostate, and others. Some adenomas grow from epithelial tissue in nonglandular areas but express glandular tissue structure. Although adenomas are benign, they should be treated as pre-cancerous. Over time adenomas may transform to become malignant, at which point they are called adenocarcinomas. Most adenomas do not transform. However, even though benign, they have the potential to cause serious health complications by compressing other structures and by producing large amounts of hormones in an unregulated, non-feedback-dependent manner. Some adenomas are too small to be seen macroscopically but can still cause clinical symptoms.

<span class="mw-page-title-main">Hypertrophy</span> Increase in the volume of an organ or tissue due to the enlargement of its component cells

Hypertrophy is the increase in the volume of an organ or tissue due to the enlargement of its component cells. It is distinguished from hyperplasia, in which the cells remain approximately the same size but increase in number. Although hypertrophy and hyperplasia are two distinct processes, they frequently occur together, such as in the case of the hormonally induced proliferation and enlargement of the cells of the uterus during pregnancy.

<span class="mw-page-title-main">Parathyroid chief cell</span>

Parathyroid chief cells are one of the two cell types of the parathyroid glands, along with oxyphil cells. The chief cells are much more prevalent in the parathyroid gland than the oxyphil cells. It is perceived that oxyphil cells may be derived from chief cells at puberty, as they are not present at birth like chief cells.

<span class="mw-page-title-main">Virilization</span> Biological development of male sex characteristics

Virilization or masculinization is the biological development of adult male characteristics in young males or females. Most of the changes of virilization are produced by androgens.

<span class="mw-page-title-main">Atrophy</span> Partial or complete wasting away of a part of the body

Atrophy is the partial or complete wasting away of a part of the body. Causes of atrophy include mutations, poor nourishment, poor circulation, loss of hormonal support, loss of nerve supply to the target organ, excessive amount of apoptosis of cells, and disuse or lack of exercise or disease intrinsic to the tissue itself. In medical practice, hormonal and nerve inputs that maintain an organ or body part are said to have trophic effects. A diminished muscular trophic condition is designated as atrophy. Atrophy is reduction in size of cell, organ or tissue, after attaining its normal mature growth. In contrast, hypoplasia is the reduction in the cellular numbers of an organ, or tissue that has not attained normal maturity.

<span class="mw-page-title-main">Endocrine gland</span> Glands of the endocrine system that secrete hormones to blood

Endocrine glands are ductless glands of the endocrine system that secrete their products, hormones, directly into the blood. The major glands of the endocrine system include the pineal gland, pituitary gland, pancreas, ovaries, testicles, thyroid gland, parathyroid gland, hypothalamus and adrenal glands. The hypothalamus and pituitary glands are neuroendocrine organs.

<span class="mw-page-title-main">Aminoglutethimide</span> Group of stereoisomers

Aminoglutethimide (AG), sold under the brand names Elipten, Cytadren, and Orimeten among others, is a medication which has been used in the treatment of seizures, Cushing's syndrome, breast cancer, and prostate cancer, among other indications. It has also been used by bodybuilders, athletes, and other men for muscle-building and performance- and physique-enhancing purposes. AG is taken by mouth three or four times per day.

<span class="mw-page-title-main">Tertiary hyperparathyroidism</span> Medical condition

Tertiary hyperparathyroidism is a condition involving the overproduction of the hormone, parathyroid hormone, produced by the parathyroid glands. The parathyroid glands are involved in monitoring and regulating blood calcium levels and respond by either producing or ceasing to produce parathyroid hormone. Anatomically, these glands are located in the neck, para-lateral to the thyroid gland, which does not have any influence in the production of parathyroid hormone. Parathyroid hormone is released by the parathyroid glands in response to low blood calcium circulation. Persistent low levels of circulating calcium are thought to be the catalyst in the progressive development of adenoma, in the parathyroid glands resulting in primary hyperparathyroidism. While primary hyperparathyroidism is the most common form of this condition, secondary and tertiary are thought to result due to chronic kidney disease (CKD). Estimates of CKD prevalence in the global community range from 11 to 13% which translate to a large portion of the global population at risk of developing tertiary hyperparathyroidism. Tertiary hyperparathyroidism was first described in the late 1960s and had been misdiagnosed as primary prior to this. Unlike primary hyperparathyroidism, the tertiary form presents as a progressive stage of resolved secondary hyperparathyroidism with biochemical hallmarks that include elevated calcium ion levels in the blood, hypercalcemia, along with autonomous production of parathyroid hormone and adenoma in all four parathyroid glands. Upon diagnosis treatment of tertiary hyperparathyroidism usually leads to a surgical intervention.

<span class="mw-page-title-main">Endometrial intraepithelial neoplasia</span>

Endometrial intraepithelial neoplasia (EIN) is a premalignant lesion of the uterine lining that predisposes to endometrioid endometrial adenocarcinoma. It is composed of a collection of abnormal endometrial cells, arising from the glands that line the uterus, which have a tendency over time to progress to the most common form of uterine cancer—endometrial adenocarcinoma, endometrioid type.

Hormonal therapy in oncology is hormone therapy for cancer and is one of the major modalities of medical oncology, others being cytotoxic chemotherapy and targeted therapy (biotherapeutics). It involves the manipulation of the endocrine system through exogenous or external administration of specific hormones, particularly steroid hormones, or drugs which inhibit the production or activity of such hormones. Because steroid hormones are powerful drivers of gene expression in certain cancer cells, changing the levels or activity of certain hormones can cause certain cancers to cease growing, or even undergo cell death. Surgical removal of endocrine organs, such as orchiectomy and oophorectomy can also be employed as a form of hormonal therapy.

In cell biology and pathophysiology, cellular adaptation refers to changes made by a cell in response to adverse or varying environmental changes. The adaptation may be physiologic (normal) or pathologic (abnormal).

<span class="mw-page-title-main">Compensatory growth (organ)</span> Type of regenerative growth

Compensatory growth is a type of regenerative growth that can take place in a number of human organs after the organs are either damaged, removed, or cease to function. Additionally, increased functional demand can also stimulate this growth in tissues and organs. The growth can be a result of increased cell size or an increase in cell division or both. For instance, if one kidney is surgically removed, the cells of the other kidney divide at an increased rate. Eventually, the remaining kidney can grow until its mass approaches the combined mass of two kidneys. Along with the kidneys, compensatory growth has also been characterized in a number of other tissues and organs including:

<span class="mw-page-title-main">Gynecomastia</span> Endocrine system disorder of human male breast

Gynecomastia is the abnormal non-cancerous enlargement of one or both breasts in males due to the growth of breast tissue as a result of a hormone imbalance between estrogens and androgens. Gynecomastia can cause significant psychological distress or unease.

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<span class="mw-page-title-main">High-dose estrogen therapy</span> Type of hormone therapy

High-dose estrogen therapy (HDE) is a type of hormone therapy in which high doses of estrogens are given. When given in combination with a high dose of progestogen, it has been referred to as pseudopregnancy. It is called this because the estrogen and progestogen levels achieved are in the range of the very high levels of these hormones that occur during pregnancy. HDE and pseudopregnancy have been used in medicine for a number of hormone-dependent indications, such as breast cancer, prostate cancer, and endometriosis, among others. Both natural or bioidentical estrogens and synthetic estrogens have been used and both oral and parenteral routes may be used.

References

  1. 1 2 "Prostate Enlargement (Benign Prostatic Hyperplasia)". National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). U.S. Department of Health and Human Services National Institutes of Health. Retrieved 2015-05-30.
  2. 1 2 Koerner FC (2009). Diagnostic Problems in Breast Pathology. Elsevier Health Sciences. ISBN   978-1-4160-2612-9.
  3. ↑ Dunphy LM, Winland-Brown JE (April 2011). Primary Care: The Art and Science of Advanced Practice Nursing. F.A. Davis. ISBN   978-0-8036-2647-8.
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  6. ↑ Zachary JF, McGavin MD (December 2013). Pathologic Basis of Veterinary Disease. Elsevier Health Sciences. ISBN   978-0-323-29172-9.
  7. ↑ Braun CA, Anderson CM (2007). Pathophysiology: Functional Alterations in Human Health . Lippincott Williams & Wilkins. p.  17. ISBN   978-0-7817-6250-2.
  8. ↑ Rubin E, Reisner HM (2009). Essentials of Rubin's Pathology. Lippincott Williams & Wilkins. ISBN   978-0-7817-7324-9.
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  15. 1 2 3 Kumar V, Abbas A, Aster J (2013). Robbins Basic Pathology. Philadelphia, US: Elsevier. p. 4. ISBN   978-0-8089-2432-6.
  16. ↑ Hong WK, Hait WN (2010). Holland Frei Cancer Medicine Eight. PMPH-USA. ISBN   978-1-60795-014-1.
  17. ↑ Kemp WL, Burns DK, Brown TG. "Pathology: The Big Picture". AccessMedicine. McGraw Hill Medical. Retrieved 2021-12-06.
  18. ↑ "Cushing disease". MedlinePlus Medical Encyclopedia. National Library of Medicine, U.S. Department of Health and Human Services National Institutes of Health. Retrieved 2015-05-30.
  19. ↑ "Congenital adrenal hyperplasia". MedlinePlus Medical Encyclopedia. National Library of Medicine, U.S. Department of Health and Human Services National Institutes of Health. Retrieved 2015-05-30.
  20. ↑ "Endometrial Hyperplasia". American College of Obstetricians and Gynecologists (ACOG). Retrieved 2015-05-30.
  21. ↑ "Hemihyperplasia - Glossary Entry". Genetics Home Reference. National Library of Medicine, U.S. Department of Health and Human Services. Retrieved 2015-05-30.
  22. ↑ Subbotin VM (October 2007). "Analysis of arterial intimal hyperplasia: review and hypothesis". Theoretical Biology & Medical Modelling. 4: 41. doi: 10.1186/1742-4682-4-41 . PMC   2169223 . PMID   17974015.
  23. ↑ Purkait SK (2011). Essentials of Oral Pathology. JP Medical Ltd. ISBN   9789350252147.
  24. ↑ Swatland, Howard (January 1974). "Developmental disorders of skeletal muscle in cattle, pigs and sheep". The Veterinary Bulletin. 44 (4): 187–189 – via ResearchGate.
  25. ↑ Evans CC, High WA (October 2011). Skin Diseases in the Elderly: A Color Handbook. CRC Press. ISBN   978-1-84076-615-8.
  26. ↑ Kumar V, Abbas AK, Aster JC (September 2014). Robbins & Cotran Pathologic Basis of Disease. Elsevier Health Sciences. ISBN   978-0-323-29635-9.

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