{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:54:55Z","timestamp":1777528495910,"version":"3.51.4"},"reference-count":21,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,8,6]],"date-time":"2025-08-06T00:00:00Z","timestamp":1754438400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Autoimmune metaplastic atrophic gastritis (AMAG) causes pulmonary trans\u2010differentiation of the gastric mucosa and is known to increase the risk of developing gastric adenocarcinoma. AMAG\u2010associated gastric adenocarcinomas were examined for immunoreactivity for TTF\u20101 and Napsin A.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Eighteen AMAG\u2010associated gastric adenocarcinomas and 36 non\u2010AMAG\u2010associated gastric adenocarcinomas were stained for TTF\u20101 (clones SP141 and 8G7G3\/1) and Napsin A (clone 1P64) by immunohistochemistry. AMAG stage and staining patterns were characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The AMAG group was older (mean age 74 vs. 65\u2009years) and was not significantly different with regard to sex or tumour differentiation. Zero (0%) AMAG cases were classified as early phase, four (22%) as florid phase and 14 (78%) as end stage. AMAG\u2010associated adenocarcinomas showed more frequent TTF\u20101 immunoreactivity compared to control adenocarcinomas in both clone SP141 (39% vs. 11%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.04) and 8G7G3\/1 (22% vs. 6%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u20090.17). AMAG\u2010associated adenocarcinomas showed more frequent Napsin A immunoreactivity compared to control adenocarcinomas (28% vs. 0%;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). Immunoreactivity in AMAG\u2010associated adenocarcinomas was patchy, ranging from 1% to 20% of tumour cells staining positive (1+ to 3+ intensity). In the AMAG cases with background gastric mucosa (n\u2009=\u200914), the background showed TTF\u20101 positive foci in seven (50%) cases (both clones) versus one (3%; clone SP141) to two (6%; clone 8G7G3\/1) of 33 controls (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01) and Napsin A positive foci in five (36%) cases versus zero (0%) controls (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u20090.01). Staining in background mucosa was also patchy, involving 1%\u201310% of gastric glands without intestinal metaplasia.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TTF\u20101 and Napsin A immunoreactivity was present in the background gastric mucosa almost exclusively in the AMAG\u2010associated cases. This immunoreactivity is also present in AMAG\u2010associated adenocarcinomas more commonly than non\u2010AMAG\u2010associated adenocarcinomas. This knowledge may aid pathologists in avoiding the pitfall of diagnosing metastatic lung cancer, as the expression is patchy and may also be seen in atrophic background mucosa.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/his.15526","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T02:40:55Z","timestamp":1754534455000},"page":"729-735","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Pulmonary immunohistochemical markers may be positive in gastric adenocarcinomas associated with autoimmune metaplastic atrophic gastritis"],"prefix":"10.1111","volume":"88","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-0312-210X","authenticated-orcid":false,"given":"Trevor","family":"Toussieng","sequence":"first","affiliation":[{"name":"The Department of Pathology &amp; Laboratory Medicine Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4306-1754","authenticated-orcid":false,"given":"Michael","family":"Kozak","sequence":"additional","affiliation":[{"name":"The Department of Pathology &amp; Laboratory Medicine Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5357-0718","authenticated-orcid":false,"given":"Miguel","family":"Burch","sequence":"additional","affiliation":[{"name":"The Division of Surgical Oncology, Department of Surgery Samuel Oschin Comprehensive Cancer Institute  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9512-7973","authenticated-orcid":false,"given":"Alexandra","family":"Gangi","sequence":"additional","affiliation":[{"name":"The Division of Surgical Oncology, Department of Surgery Samuel Oschin Comprehensive Cancer Institute  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8713-1406","authenticated-orcid":false,"given":"Jun","family":"Gong","sequence":"additional","affiliation":[{"name":"The Department of Medicine, Division of Hematology and Oncology Samuel Oschin Comprehensive Cancer Institute  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4864-6498","authenticated-orcid":false,"given":"Maha","family":"Guindi","sequence":"additional","affiliation":[{"name":"The Department of Pathology &amp; Laboratory Medicine Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5727-6900","authenticated-orcid":false,"given":"Keith K","family":"Lai","sequence":"additional","affiliation":[{"name":"The Department of Pathology &amp; Laboratory Medicine Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3188-0525","authenticated-orcid":false,"given":"Danielle A","family":"Hutchings","sequence":"additional","affiliation":[{"name":"The Department of Pathology &amp; Laboratory Medicine Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8116-1089","authenticated-orcid":false,"given":"Brent K","family":"Larson","sequence":"additional","affiliation":[{"name":"The Department of Pathology &amp; Laboratory Medicine Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2140-3514","authenticated-orcid":false,"given":"Kevin M","family":"Waters","sequence":"additional","affiliation":[{"name":"The Department of Pathology &amp; Laboratory Medicine Cedars\u2010Sinai Medical Center  Los Angeles CA USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,6]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF01071995"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2012.09.033"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrgastro.2013.101"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e3181f623af"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2021.06.078"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(74)92013-3"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365521.2015.1010570"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1006\/clin.1997.4412"},{"key":"e_1_2_12_10_1","first-page":"88","article-title":"Clinical manifestations of chronic atrophic gastritis","volume":"89","author":"Rodriguez\u2010Castro KI","year":"2018","journal-title":"Acta Biomed"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000000481"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3880499"},{"key":"e_1_2_12_13_1","volume-title":"Diagnostic pathology: gastrointestinal","author":"Greenson J","year":"2024"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-023-02055-x"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.15259"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21834"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jso.23262"},{"key":"e_1_2_12_18_1","first-page":"67","article-title":"The incidence of neoplasia in patients with autoimmune metaplastic atrophic gastritis: a renewed call for surveillance","volume":"32","author":"Mahmud N","year":"2018","journal-title":"Ann. 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