Surgical Pathology Criteria

Traditional Serrated Adenoma of the Appendix

Differential Diagnosis

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 Mucinous Adenoma
Prominent glandular serration No serrated/hyperplastic appearance
Typically complex architecture Flat with areas of short villi
Distinction may be difficult in lesions compressed by mucin

 

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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