1) To review the spectrum and pathologic backgrounds of endocervical glandular lesions showing gastric differentiation, which is a quite bland new entity described recently. 2) To learn the characteristics of clinical, pathologic and MRI features in these endocervical glandular lesions of gastric phenotype in correlation with pathologic findings, and to know the imaging findings for differentiating benign and malignant conditions. 3) To learn the appropriate management in patients with these entities.

1)The histologic spectrum of the entity Endocervical glandular lesions showing gastric differentiation are an emerging entity, which is characterized by the immune reactivity for gastric markers such as HIK1083 and MUC6[1]. This entity consists of a spectrum of lesions, ranging from benign condition represented by lobular endocervical glandular hyperplasia (LEGH) to adenocarcinomas. Adenocarcinomas with gastric differentiation consist of gastric-type mucinous adenocarcinoma (GAS) and minimal deviation adenocarcinoma (MDA), which was previously called adenoma malignum (Fig. 1 . MDA is now conceptually included in GAS as an...

Imaging findings I.Malignant endocervical glandular lesions showing gastric differentiation 1) Clinical features 　　　GAS commonly affects middle aged women, with age range from 37 to 84 years old, with mean age of 42 years old [2; 3]. The typical presentation is vaginal bleeding or increased mucinous discharge. Although the clinical courses of GAS have not been extensively studied, it is thought GAS is associated with aggressive behavior and a poor prognosis, with propensity for peritoneal and adnexal involvement. The patients commonly present with higher stage than...

Endocervical glandular lesions showing gastric differentiation are an emerging entity, encompassing LEGH and GAS, including MDA. MRI features of GAS are characterized by the endophytic and infiltrative growth pattern into the cervical stroma without forming masses, and the presence of cysts. Meanwhile, those in LEGH is characterized by the multiple cysts arranged in a floret-like manner (cosmos sign) and soft tissue in its central portion. The most important MRI finding for diagnosing LEGH is the negative finding for an infiltrative mass beyond the deeply located...

Takashi Koyama MD, PhD Dept. of Diagnostic Radiology, Kurashiki Central Hospital 1-1-1 Miwa, Kurashiki, Okayama, 710-8602 Japan

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