Department of Pathology, United Christian Hospital, Kwun Tong, Hong Kong.
Department of Pathology, Royal Children's Hospital and Royal Women's Hospital, Melbourne, Australia.
Histopathology. 2024 Jul;85(1):20-39. doi: 10.1111/his.15174. Epub 2024 Mar 13.
In the last two decades or so, a spectrum of benign, premalignant and malignant cervical glandular lesions exhibiting gastric differentiation has been described, with gastric-type adenocarcinoma representing the most common human papillomavirus (HPV)-independent cervical adenocarcinoma. More recently, limited literature has reported a variety of gastric-type glandular lesions at other sites within the female genital tract and, as in the cervix (the most common site for these lesions), a spectrum of benign, premalignant and malignant lesions has been proposed. We provide an update and review of the emerging spectrum of gastric-type glandular lesions at female genital tract sites other than the cervix. In the endometrium, putative gastric-type glandular lesions include mucinous metaplasia of gastric-type, atypical mucinous proliferation of gastric-type and gastric-type adenocarcinoma. Similarly in the vagina, gastric-type adenosis, atypical adenosis and adenocarcinoma have been described. There have also been occasional reports of gastric-type lesions involving the ovary and fallopian tube. We provide guidance on how to recognise gastric-type lesions morphologically and immunophenotypically and stress that sometimes these lesions occur at more than one site within the female genital tract (synchronous/multifocal gastric-type lesions of the female genital tract), sometimes in association with Peutz-Jeghers syndrome.
在过去的二十年左右，描述了一系列表现出胃分化的良性、癌前和恶性宫颈腺病变，其中胃型腺癌是最常见的人乳头瘤病毒（HPV）无关的宫颈腺癌。最近，有限的文献报道了女性生殖道其他部位存在多种胃型腺病变，与宫颈（这些病变最常见的部位）一样，提出了一系列良性、癌前和恶性病变。我们提供了对除宫颈以外的女性生殖道部位胃型腺病变不断发展的新认识的更新和综述。在子宫内膜中，推测的胃型腺病变包括胃型黏液性化生、胃型非典型黏液性增生和胃型腺癌。同样，在阴道中，也描述了胃型腺病、非典型腺病和腺癌。偶尔也有报道涉及卵巢和输卵管的胃型病变。我们提供了如何在形态学和免疫表型上识别胃型病变的指导，并强调这些病变有时会出现在女性生殖道的一个以上部位（女性生殖道的同步/多灶性胃型病变），有时与 Peutz-Jeghers 综合征有关。
