GENERAL FEATURES
The normal (euplastic) nuclear pattern of epithelial and mesenchymal cells changes to reflect various adaptive activities. Most often, the cytoplasm is secondarily affected to express nuclear alterations resulting from prolonged stimulation, sustained degeneration (regression), and/or sudden irreversible death. It is important to examine the nuclear changes carefully when evaluating altered cells activity.
INCREASED FUNCTIONAL ACTIVITY (INCREASED ACTIVITY, REGENERATION, STIMULATION, REACTIVE ATYPIA)
Whenever stimulated and challenged in a slow and graduated fashion, tissues react and respond in two ways in growth activity: (i) hypertrophy, and (ii) hyperplasia. In the hypertrophic state there is an increase in the size of cells, while in hyperplasia there is an associated increase in the number of cells. In certain tissues, the two growth activities may occur simultaneously. For example, striated and cardiac muscles may react, enlarge and become hypertrophic. Epithelial cells such as those derived from endocervix, bronchial, and intestinal mucosa may respond by producing additional cells, i.e. hyperplasia. It must be realized that in most situations the cells represent a galaxy of changes occurring in the tissues being sampled, including regeneration, degeneration, “atypical”, and neoplastic alterations. Variable mitosis may be seen in the cells.
Cells as a whole
In cells derived from the cervical squamous epithelium, Papanicolaou recognized dyskaryosis (a state of abnormal nuclei) which, even though it has subsequently been greatly abused and confused, is a useful term and concept. Both the nuclei and cytoplasm of these dyskaryotic cells undergo morphologic changes which are good indicators of the quality and severity of the underlying processes.
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