Endocervical gastric-type AIS: a rare histologic finding that further supports the hypothesis of a pyloric-type metaplastic origin.
Michele Paudice, Veronica Parrella, Giulia Scaglione
✦ AI-curated · Sources linked
Case in brief
A 70-year-old woman had atypical glandular cells on Pap testing and negative HPV molecular testing. Cervical conization showed atypical glandular epithelium diagnosed as gastric-type adenocarcinoma in situ (gAIS). The lesion was positive for CK7 and CDX2, showed mutant-type p53 expression, and was negative for CK20, PAX8, and p16. Pyloric-type gastric metaplasia was present adjacent to the lesion. The findings supported a possible association between gAIS and pyloric-type metaplasia.
What made this case unusual
Pyloric-type gastric metaplasia adjacent to gAIS provides morphologic support for a possible metaplastic origin, while the HPV-negative presentation and immunophenotype pose diagnostic challenges, particularly in limited samples.
Diagnostic / clinical pearl
In HPV-negative cervical glandular lesions, recognize that gAIS may be associated with adjacent pyloric-type gastric metaplasia; histologic assessment and immunohistochemistry can aid diagnosis.