Endocervical gastric‐type <scp>AIS</scp> : a rare histologic finding that further supports the hypothesis of a pyloric‐type metaplastic origin

BACKGROUND: Gastric-type adenocarcinoma in situ (gAIS) is a rare, HPV-independent precursor of cervical adenocarcinoma with incompletely defined histogenesis. AIMS: To report a case of gAIS and its association with pyloric-type gastric metaplasia. MATERIALS AND METHODS: A case of gAIS in a 70-year-old woman with atypical glandular cells (Pap test) and negative HPV molecular testing was evaluated histologically and immunohistochemically. RESULTS: Conization revealed atypical glandular epithelium. The lesion was CK7/CDX2 positive, with mutant-type p53 expression, and negative for CK20, PAX8 and p16. Adjacent pyloric-type gastric metaplasia was identified. DISCUSSION: The association with pyloric-type metaplasia supports a possible metaplastic origin and highlights diagnostic challenges in limited samples. CONCLUSION: This case supports a possible link between gAIS and pyloric-type gastric metaplasia, underscoring the importance of accurate recognition in HPV-independent cervical lesions.