Cell injury and adaptation: metaplasia in schistosomiasis: practice question

A Pathology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pathology · Cell injury and adaptation: metaplasia in schistosomiasis

Sample item

A 40-year-old farmer from the Nile delta has had terminal haematuria for years. Cystoscopy shows granular mucosa, and a biopsy of the chronically inflamed bladder shows mature squamous epithelium where urothelium is expected. What is this adaptive change and what does it predispose to?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Squamous metaplasia, predisposing to squamous cell carcinoma

Chronic irritation from Schistosoma haematobium eggs makes reserve cells reprogram so that squamous epithelium replaces urothelium. This metaplasia is reversible in principle but carries a risk of squamous cell carcinoma if the irritation persists. The same concept explains squamous carcinoma in some bladder stones and chronic cystitis.

Option by option

  • A. Mucosal atrophy, predisposing to lymphoma

    Atrophy means shrinkage of the epithelium and has no link to this lymphoma.

  • B. Glandular metaplasia, predisposing to adenocarcinoma

    Glandular change would show columnar or mucin-secreting cells, not mature squamous cells.

  • C. Squamous metaplasia, predisposing to squamous cell carcinoma (correct)

    Correct. Squamous epithelium replacing urothelium under chronic irritation can progress to squamous carcinoma.

  • D. Urothelial hyperplasia, predisposing to papillary carcinoma

    Hyperplasia increases the number of urothelial cells and keeps the normal cell type.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pathology question

What is the answer to this Pathology question?

The best answer is C, Squamous metaplasia, predisposing to squamous cell carcinoma. Chronic irritation from Schistosoma haematobium eggs makes reserve cells reprogram so that squamous epithelium replaces urothelium.

Why is "Mucosal atrophy, predisposing to lymphoma" not the answer?

Atrophy means shrinkage of the epithelium and has no link to this lymphoma.

Why is "Glandular metaplasia, predisposing to adenocarcinoma" not the answer?

Glandular change would show columnar or mucin-secreting cells, not mature squamous cells.

Why is "Urothelial hyperplasia, predisposing to papillary carcinoma" not the answer?

Hyperplasia increases the number of urothelial cells and keeps the normal cell type.

What concept does this question test?

It tests Cell injury and adaptation: metaplasia in schistosomiasis in Pathology. This metaplasia is reversible in principle but carries a risk of squamous cell carcinoma if the irritation persists. The same concept explains squamous carcinoma in some bladder stones and chronic cystitis.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Cell injury and adaptation: metaplasia in schistosomiasis?

Learn each disease as a bundle: cause, key histology, markers, and the clinical hallmark. Then use the flashcards and the other Pathology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.