Malignant dysplasia

Precancerous cells have cellular changes that are abnormal but not yet malignant and may be described as hyperplastic or dysplastic. Hyperplasia occurs when a stimulus is introduced and reverses when the stimulus is removed. Dysplasia is an abnormal change in the size, shape, or organization of cells or tissues. 

Close clinical surveillance of all women taking OCs is essential they should be reexamined at least once a year. In all cases of undiagnosed persistent or recurrent abnormal vaginal bleeding, rule out malignancy. Monitor women with a strong family history of breast cancer or who have breast nodules, fibrocystic disease of the breast, cervical dysplasia, or abnormal mammograms. 

Patients with frequent relapses despite apparently adequate prophylactic treatment should be reviewed carefully. Associated milk intolerance or coeliac disease need treatment on their merits. Colonoscopic evidence of dysplasia raises the question of undiagnosed malignancy. Occasionally the prophylactic agents themselves can cause watery diarrhoea (particularly olsalazine) or a hypersensitivity colitic disease. Prophylactic azathioprin should be considered in those in whom relapse is frequent despite use of aminosalicylates or if they are poorly tolerated. In the effective dose of 2 mg/kg adverse effects of bone marrow depression are uncommon, but still occur, and regular haematological review is essential (monthly or bi-monthly). Azathioprin-induced pancreatitis is an uncommon but well-recognised entity. 

Cervical carcinoma. Smoke condensate, in human papillomavirus 18-immortalized ectocervical cells (HEC-18-1C), produced an invasive squamous cell carcinoma, from which was established a clonal line of cells (HEC-18-1CT). The moderate passage malignantly transformed HEC-18-1CT displayed severe dysplasia/carcinoma in situ in raft culture . 

What is of potential concern is that in this case, as in a very few previously described, there was also evidence of hepatocellular dysplasia, which could be a pre-malignant condition. However, with widespread use of Norplant, some reported adverse events, such as this, may be purely coincidental. 

Because of fear of malignancies the Belgian researchers who first described the condition have advocated prophylactic removal of the kidneys and ureters in patients with Chinese herb nephropathy. Of 39 patients who agreed to this, 18 (46%) had urothelial carcinoma, 19 of the others had mild to moderate urothelial dysplasia, and only two had normal urothelium (28). All tissue samples contained... 

Erosions or a superficial ulceration of the mucosa can occur focally or diffusely. Erosions are due to focal necrosis of the epithelium and associated stroma and are restricted to the superficial layers. Diffuse irritation accompanied by an inflammatory reaction is called enteritis. Ulcers, in contrast, are deeper lesions extending beyond the mucosa and penetrating into the adjacent tissue layers. Chronic irritation can produce proliferative lesions including dysplasia, which potentially could become malignant. 

Lentigo maligna is also known as DubreuUh s melanosis and Hutchinson s freckle. Different authors consider it either as a malignant melanoma in situ or as a premalignant melanocytic dysplasia. 

Hyperplastic (candidal leukoplakia) Smokers uncommon in patients with HIV Thick white and adherent keratotic plaques commonly seen on the buccal mucosa and lateral border of tongue may also see on lips and bottom of mouth plaques cannot be easily scraped offer only partially removed. This condition is distinct from oral hairy leukoplakia, and it may progress to severe dysplasia or malignancy. 

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