Gastric‐type glandular lesions of the female genital tract excluding the cervix: emerging pathological entities

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.