{"id":6067,"date":"2023-03-17T08:42:56","date_gmt":"2023-03-17T08:42:56","guid":{"rendered":"https:\/\/www.eurocytology.eu\/course\/la-union-escamocolumnar-cambio-metaplastico-y-la-zona-de-transformacion\/"},"modified":"2023-04-26T07:20:55","modified_gmt":"2023-04-26T07:20:55","slug":"la-union-escamocolumnar-cambio-metaplastico-y-la-zona-de-transformacion","status":"publish","type":"course","link":"https:\/\/www.eurocytology.eu\/es\/course\/la-union-escamocolumnar-cambio-metaplastico-y-la-zona-de-transformacion\/","title":{"rendered":"La uni\u00f3n escamocolumnar, cambio metapl\u00e1stico y la zona de transformaci\u00f3n"},"content":{"rendered":"<div data-object_id=\"6067\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_guest cbxwpbkmarkwrap_user_cat cbxwpbkmarkwrap-course \"><a  data-redirect-url=\"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/6067\/\"  data-display-label=\"1\" data-show-count=\"1\" data-bookmark-label=\"Bookmark\"  data-bookmarked-label=\"Bookmarked\"  data-loggedin=\"0\" data-type=\"course\" data-object_id=\"6067\" class=\"cbxwpbkmarktrig  cbxwpbkmarktrig-button-addto\" title=\"Bookmark This\" href=\"#\"><span class=\"cbxwpbkmarktrig-label\" >Bookmark (<i class=\"cbxwpbkmarktrig-count\">0<\/i>)<\/span><\/a> <div  data-type=\"course\" data-object_id=\"6067\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-6067\"><div class=\"cbxwpbkmarkguest-message\"><a href=\"#\" class=\"cbxwpbkmarkguesttrig_close\"><\/a><h3 class=\"cbxwpbookmark-title cbxwpbookmark-title-login\">Please login to bookmark<\/h3><form name=\"loginform\" id=\"loginform\" action=\"https:\/\/www.eurocytology.eu\/wp-login.php\" method=\"post\"><p class=\"login-username\">\n\t\t\t\t<label for=\"user_login\">Nombre de usuario o correo electr\u00f3nico<\/label>\n\t\t\t\t<input type=\"text\" name=\"log\" id=\"user_login\" autocomplete=\"username\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-password\">\n\t\t\t\t<label for=\"user_pass\">Contrase\u00f1a<\/label>\n\t\t\t\t<input type=\"password\" name=\"pwd\" id=\"user_pass\" autocomplete=\"current-password\" spellcheck=\"false\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-remember\"><label><input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/> Recu\u00e9rdame<\/label><\/p><p class=\"login-submit\">\n\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Acceder\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/6067\/\" \/>\n\t\t\t<\/p><\/form><p class=\"cbxwpbookmark-guest-register\">No account yet? <a href=\"https:\/\/www.eurocytology.eu\/es\/register\/?redirect_to=https%3A%2F%2Fwww.eurocytology.eu%2Fes%2Fwp-json%2Fwp%2Fv2%2Fcourse%2F6067%2F\">Register<\/a><\/p><\/div><\/div><\/div><p><span style=\"line-height: 1.55;\">La uni\u00f3n escamocolumnar est\u00e1 localizada en el punto donde el epitelio plano y el epitelio cil\u00edndrico se encuentran. La localizaci\u00f3n de este punto var\u00eda durante la vida de la mujer debido a los cambios metapl\u00e1sticos en el epitelio cervical que ocurren despu\u00e9s de la pubertad y durante el embarazo. La zona de transformaci\u00f3n es el nombre asignado al \u00e1rea del cuello uterino compuesta de epitelio que ha sufrido cambio metapl\u00e1stico.<\/span><\/p>\n<h3>Definici\u00f3n de metaplasia<\/h3>\n<ul>\n<li>\n<p>Metaplasia es el nombre dado al proceso por el cual un tipo de epitelio completamente diferenciado se transforma en otro.<\/p>\n<\/li>\n<li>\n<p>Es usualmente un proceso adaptativo que ocurre en reacci\u00f3n a irritaci\u00f3n cr\u00f3nica de cualquier clase, o como respuesta a est\u00edmulos hormonales.<\/p>\n<\/li>\n<li>\n<p>El cambio metapl\u00e1sico es reversible y te\u00f3ricamente el epitelio transformado puede revertir al epitelio original despu\u00e9s que el est\u00edmulo ha desaparecido, pero esto no siempre ocurre.<\/p>\n<\/li>\n<li>\n<p>La metaplasia ocurre en muchos sitios del cuerpo p. ej la mucosa g\u00e1strica, la vejiga, los bronquios etc. El proceso metapl\u00e1sico del cuello uterino ha sido estudiado en detalle.<\/p>\n<\/li>\n<\/ul>\n<p><strong>En el cuello uterino, el cambio metapl\u00e1stico implica la transformaci\u00f3n del epitelio endocervical en un epitelio escamoso.<\/strong><\/p>\n<p>Tres etapas histol\u00f3gicas han sido identificadas:<\/p>\n<ul>\n<li>\n<p><strong>Etapa 1<\/strong>&nbsp;: Hiperplasia de c\u00e9lulas de reserva &#8211; las c\u00e9lulas de reserva en el epitelio endocervical empiezan a dividirse.<\/p>\n<\/li>\n<li>\n<p><strong>Etapa 2<\/strong>: Metaplasia plana inmadura &#8211; las c\u00e9lulas de reserva proliferan para formar m\u00faltiples capas de c\u00e9lulas indiferenciadas. Una capa superficial de c\u00e9lulas cil\u00edndricas mucinosas se puede ver frecuentemente en la superficie.<\/p>\n<\/li>\n<li>\n<p><strong>Etapa 3<\/strong>: Metaplasia plana madura &#8211; las c\u00e9lulas indiferenciadas se diferencian en epitelio plano maduro que es casi indistingible del epitelio plano original.<\/p>\n<\/li>\n<\/ul>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img fetchpriority=\"high\" decoding=\"async\" alt=\"\" height=\"305\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/mod1img4a.jpg?itok=rWWPu600\" width=\"474\" \/><\/a><figcaption>Histological section to illustrate reserve cell hyperplasia in the glandular epithelium of the cervix.&nbsp;Note the proliferation of the reserve cells deep to the endocervical epithelium.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img decoding=\"async\" alt=\"\" height=\"289\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/mod1img4b.jpg?itok=YfjPEA45\" width=\"474\" \/><\/a><figcaption>Histological section to illustrate immature squamous metaplastic epithelium in the cervix.&nbsp;Note the tendency of the reserve cells to stratify with a corresponding increase in the amount and density of the cytoplasm. The original columnar epithelium appears as a distinct layer on the surface of the immature metaplastic epithelium.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img decoding=\"async\" alt=\"\" height=\"451\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/mod1img4c.jpg?itok=TChTDKud\" width=\"474\" \/><\/a><figcaption>Histological section to illustrate mature squamous metaplastic epithelium in the cervix.&nbsp;The immature metaplastic epithelium has transformed into a fully mature metaplastic stratified squamous epithelium virtually indistinguishable from the original (native) squamous epithelium.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"314\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/mod1img4d.jpg?itok=p1PUisCj\" width=\"474\" \/><\/a><figcaption>Illustrates metaplastic change from columnar to squamous epithelium in the uterine cervix.&nbsp;Note position of squamo columnar junction (arrow). Note the glandular epithelium deep to the metaplastic squamous epithelium.<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<h3>Cambio metapl\u00e1sico en el cuello uterino y sus bases fisiol\u00f3gicas<\/h3>\n<ul>\n<li>\n<p>Desde el nacimiento hasta la pubertad, el epitelio endocervical es cil\u00edndrico, y el ectocervix se compone de epitelio plano nativo. La interfase entre estos dos se llama uni\u00f3n escamocolumnar original.<\/p>\n<\/li>\n<li>\n<p>Durante la pubertad y el primer embarazo el cuello uterino aumenta de volumen en respuesta a cambios hormonales. El epitelio endocervical se evierte al ectocervix (portio vaginalis) exponi\u00e9ndose al pH \u00e1cido de la vagina. Esto proporciona un est\u00edmulo para el cambio metapl\u00e1sico del epitelio cil\u00edndrico.<\/p>\n<\/li>\n<li>\n<p>Cambio metapl\u00e1sico en el cuello uterino y sus bases fisiol\u00f3gicas . Desde el nacimiento hasta la pubertad, el epitelio endocervical es cil\u00edndrico, y el ectocervix se compone de epitelio plano nativo. La interfase entre estos dos se llama uni\u00f3n escamocolumnar original. . Durante la pubertad y el primer embarazo el cuello uterino aumenta de volumen en respuesta a cambios hormonales. El epitelio endocervical se evierte al ectocervix (portio vaginalis) exponi\u00e9ndose al pH \u00e1cido de la vagina. Esto proporciona un est\u00edmulo para el cambio metapl\u00e1sico del epitelio cil\u00edndrico. . El proceso de metaplasia es desigual: comienza en las criptas y en la punta de las vellosidades endocervicales que gradualmente se fusionan. Finalmente la totalidad del epitelio endocervical evertido se reemplaza por epitelio plano.<\/p>\n<\/li>\n<\/ul>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"223\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/tz1.jpg?itok=FKzNVcJu\" width=\"300\" \/><\/a><figcaption>Squamocolumnar junction prior to puberty.<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"220\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/tz2.jpg?itok=9hd1BylC\" width=\"300\" \/><\/a><figcaption>Eversion of the endocervical epithelium at puberty and first pregnancy<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"222\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/tz3.jpg?itok=oINRtmKI\" width=\"300\" \/><\/a><figcaption>Metaplastic change of endocervical epithelium in the transformation zone<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"221\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/tz4.jpg?itok=u8qiYbsx\" width=\"300\" \/><\/a><figcaption>Relocation of SCJ in the endocervical canal after the menopause<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n<p>Nom\u00e9nclatura:<\/p>\n<ul>\n<li>1: Epitelio plano nativo<\/li>\n<li>2: Epitelio cil\u00edndrico del endocervix<\/li>\n<li>3: Uni\u00f3n escamocolumnar (SCJ)<\/li>\n<li>4: Eversi\u00f3n del epitelio endocervical<\/li>\n<li>5: Cambio metapl\u00e1stico en la zona de transformaci\u00f3n<\/li>\n<\/ul>\n<p>Significado cl\u00ednico de la metaplasia plana en el cuello uterino<\/p>\n<p>En el cuello uterino, el \u00e1rea de epitelio que ha sufrido cambio metapl\u00e1stico se llama la zona de transformaci\u00f3n (TZ). Numerosos estudios han demostrado que las c\u00e9lulas epiteliales metapl\u00e1sicas inmaduras son susceptibles a carcinogenos, y muchos, si no todos, los c\u00e1nceres de cuello cervical se original en esta \u00e1rea.<\/p>\n<h2>Other forms of metaplastic change in the cervix<\/h2>\n<h3>Tuboendometriod metaplasia<\/h3>\n<p>This&nbsp; pattern of metaplastic change often occurs after&nbsp; surgical cone biopsy, diathermy loop biopsy or LLETZ biopsy. Histologically it is characterised by tuboendometrioid glands in the endocervix well away from the uterine isthmus. A key feature of tuboendometrioid change is that there is no associated endometrial stroma The metaplastic epithelium&nbsp; exhibit endometrial features including&nbsp; pseudostratification&nbsp; of the columnar cell nuclei,&nbsp; nuclear hyperchromasia, secretory apical snouting in addition to luminal ciliation.<\/p>\n<p>In cervical smears,&nbsp; tuboendometrioid metaplastic changes&nbsp; may be misinterpreted as glandular neoplasia as the cells may form rather ragged crowded groups. However the absence of feathering and rosette formation and the uniform size and shape and the fine chromatin&nbsp; structure of the individual nuclei &nbsp;should permit the correct diagnosis. The presence of&nbsp; a ciliated cell border&nbsp; is diagnostic although a rare finding. (<strong>see also Section on Pitfalls of Diagnosis&nbsp; in Module 10<\/strong>.)<\/p>\n<h3>Intestinal metaplasia<\/h3>\n<p>This pattern is characterised by the presence of goblet cells in the cervical epithelium and has been found in glandular neoplasms of the cervix.<\/p>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"204\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/LP1ContentAcontD_clip_image002_0000.jpg?itok=aNdqxcH6\" width=\"281\" \/><\/a><figcaption>Case 1 &#8211; Tubal metaplasia of cervix Histology and cytology<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"190\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/LP1ContentAcontD_clip_image002.jpg?itok=PH_tXOwc\" width=\"281\" \/><\/a><figcaption>Case 1 &#8211; Tubal metaplasia of cervix Histology and cytology<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"208\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/LP1ContentAcontD_clip_image002_0001.jpg?itok=uQvJ9t3w\" width=\"286\" \/><\/a><figcaption>Case 2 &#8211; Tubal metaplasia of cervix Histology and cytology<\/figcaption><\/figure>\n<figure><a data-toggle=\"modal\" href=\"#modal-container-2\"><img loading=\"lazy\" decoding=\"async\" alt=\"\" height=\"204\" src=\"http:\/\/lnx.eurocytology.eu\/sites\/default\/files\/styles\/max\/public\/images\/LP1ContentAcontD_clip_image002_0002.jpg?itok=JWB8JbXy\" width=\"262\" \/><\/a><figcaption>Case 2 &#8211; Tubal metaplasia of cervix Histology and cytology<\/figcaption><\/figure>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<div data-object_id=\"6067\" class=\"cbxwpbkmarkwrap cbxwpbkmarkwrap_guest cbxwpbkmarkwrap_user_cat cbxwpbkmarkwrap-course \"><a  data-redirect-url=\"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/6067\/\"  data-display-label=\"1\" data-show-count=\"1\" data-bookmark-label=\"Bookmark\"  data-bookmarked-label=\"Bookmarked\"  data-loggedin=\"0\" data-type=\"course\" data-object_id=\"6067\" class=\"cbxwpbkmarktrig  cbxwpbkmarktrig-button-addto\" title=\"Bookmark This\" href=\"#\"><span class=\"cbxwpbkmarktrig-label\" >Bookmark (<i class=\"cbxwpbkmarktrig-count\">0<\/i>)<\/span><\/a> <div  data-type=\"course\" data-object_id=\"6067\" class=\"cbxwpbkmarkguestwrap\" id=\"cbxwpbkmarkguestwrap-6067\"><div class=\"cbxwpbkmarkguest-message\"><a href=\"#\" class=\"cbxwpbkmarkguesttrig_close\"><\/a><h3 class=\"cbxwpbookmark-title cbxwpbookmark-title-login\">Please login to bookmark<\/h3><form name=\"loginform\" id=\"loginform\" action=\"https:\/\/www.eurocytology.eu\/wp-login.php\" method=\"post\"><p class=\"login-username\">\n\t\t\t\t<label for=\"user_login\">Nombre de usuario o correo electr\u00f3nico<\/label>\n\t\t\t\t<input type=\"text\" name=\"log\" id=\"user_login\" autocomplete=\"username\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-password\">\n\t\t\t\t<label for=\"user_pass\">Contrase\u00f1a<\/label>\n\t\t\t\t<input type=\"password\" name=\"pwd\" id=\"user_pass\" autocomplete=\"current-password\" spellcheck=\"false\" class=\"input\" value=\"\" size=\"20\" \/>\n\t\t\t<\/p><p class=\"login-remember\"><label><input name=\"rememberme\" type=\"checkbox\" id=\"rememberme\" value=\"forever\" \/> Recu\u00e9rdame<\/label><\/p><p class=\"login-submit\">\n\t\t\t\t<input type=\"submit\" name=\"wp-submit\" id=\"wp-submit\" class=\"button button-primary\" value=\"Acceder\" \/>\n\t\t\t\t<input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/www.eurocytology.eu\/es\/wp-json\/wp\/v2\/course\/6067\/\" \/>\n\t\t\t<\/p><\/form><p class=\"cbxwpbookmark-guest-register\">No account yet? <a href=\"https:\/\/www.eurocytology.eu\/es\/register\/?redirect_to=https%3A%2F%2Fwww.eurocytology.eu%2Fes%2Fwp-json%2Fwp%2Fv2%2Fcourse%2F6067%2F\">Register<\/a><\/p><\/div><\/div><\/div><p>La uni\u00f3n escamocolumnar est\u00e1 localizada en el punto donde el epitelio plano y el epitelio cil\u00edndrico se encuentran. La localizaci\u00f3n de este punto var\u00eda durante la vida de la mujer debido a los cambios metapl\u00e1sticos en el epitelio cervical que ocurren despu\u00e9s de la pubertad y durante el embarazo. La zona de transformaci\u00f3n es el [&hellip;]<\/p>\n","protected":false},"featured_media":0,"parent":0,"menu_order":0,"template":"","meta":[],"tags":[],"course_area":[112],"authors":[],"class_list":["post-6067","course","type-course","status-publish","hentry","course_area-cervix"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v22.6 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>La uni\u00f3n escamocolumnar, cambio metapl\u00e1stico y la zona de transformaci\u00f3n - Eurocytology<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.eurocytology.eu\/es\/course\/la-union-escamocolumnar-cambio-metaplastico-y-la-zona-de-transformacion\/\" \/>\n<meta property=\"og:locale\" content=\"es_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"La uni\u00f3n escamocolumnar, cambio metapl\u00e1stico y la zona de transformaci\u00f3n - Eurocytology\" \/>\n<meta property=\"og:description\" content=\"La uni\u00f3n escamocolumnar est\u00e1 localizada en el punto donde el epitelio plano y el epitelio cil\u00edndrico se encuentran. 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