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Squamous Epithelial Metaplasia in the Respiratory Tract in Uraemics : A Preliminary Report on a Study of Post Mortem Cases

British Journal of Cancer
Nature Publishing Group
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224i SQUAMOUS EPITHELIAL METAPLASIA IN THE RESPIRATORY TRACT IN URAEMICS A PRELIMINARY REPORT ON A STUDY OF POST MORTEM CASES K. SANDERUD From The Gade Institute, Department of Pathology, University of Bergen, Norway Received for publication February 23, 1956 BY squamous epithelial metaplasia in the respiratory tract is meant a substi- tution of columnar cell epithelium by squamous epithelium, stratified in at least 3 distinct cell layers. Changes of this nature have been observed in connection with both acute and chronic irritations of the respiratory tract (Askanazy, 1919; Niskanen, 1949; Wegelin, 1919; Weller, 1953; Weller, 1955. personal communication), and also in cases of vitamin A deficiency as part of a more general epithelial alteration. Metaplasia in the respiratory tract is of particular interest as a possible pre- cancerous condition. In a systematic investigation of epithelium in the respiratory tract in over 200 autopsies, we were struck by unusually marked and widespread metaplastic changes in a young man belonging to an age group where metaplasia was otherwise rare. The patient died of uraemia following a subacute glomerulonephritis. There were no other known causes of epithelial metaplasia which offered a natural explanation of the changes observed in this case. Our autopsy material was therefore examined with a view to metaplasia in uraemia. In 45 cases under 20 years of age only six had metaplasia, and one of these six, the above mentioned young man (Case 1), died of uraemia caused by kidney disease. The adult material is summarized in Table I. In 169 adults there were 44 men and 29 women with uraemia. There appeared to be some preponderance of metaplasia in this group of uraemics compared with its incidence in the total number of cases (Table I). The difference, however, was not significant. Several of these cases had had uraemia of short duration as a terminal stage of some other disease, such as circulatory failure, surgical abdominal diseases, or acute urin

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