Surgical Pathology Criteria

Sessile Serrated Polyp/Adenoma of the Appendix

Differential Diagnosis

Appendiceal hyperplastic polyp should be distinguished from appendiceal sessile serrated adenoma using the same features as in the colorectum

Appendiceal Hyperplastic Polyp / Mucosal Hyperplasia Appendiceal Sessile Serrated Polyp/Adenoma
Bases of crypts straight, regular, frequently pointed Crypts dilated, branched, occasional horizontal bases
Serrations restricted to upper part of glands Serrations may involve base
Proliferative zone reliably restricted to base Proliferative zone frequently irregularly displaced upwards from the base
The distinction may be particularly difficult in the appendix
Both are benign if completely excised and completely sectioned

 

Appendiceal traditional serrated adenoma should be distinguished from appendiceal sessile serrated adenoma using the same features as in the colorectum
Appendiceal Traditional Serrated Adenoma Appendiceal Sessile Serrated Polyp/Adenoma
Cytologic dysplasia throughout Cytologic dysplasia, if present, is a focal lesion
Typically complex architecture Minor architectural disturbances but overall, crypts are vertically arranged and not complex
Significance of the distinction in the appendix is not clear
Both are benign if completely excised and completely sectioned

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