Traditional Serrated Adenoma of the Appendix
Definition
- Serrated appendiceal polyp with generalized cytologic dysplasia
Diagnostic Criteria
- Histologic features of colorectal TSA
- Prominent serration of glands
- Usually columnar cells with mucin depleted eosinophilic cytoplasm
- Cytologic low grade dysplasia throughout
- Hyperchromatic elongate nuclei
- Frequent nuclear stratification
- Complex architecture
- Budding and branching of glands similar to usual tubular adenomas
- One study found 4 of 10 appendiceal TSA to have associated invasive carcinoma (Rubio 2004)
- Unequivocal diagnosis of TSA should be made only if the appendix has been entirely sectioned and the margins of resection are clear
- No relationship to pseudomyxoma peritonei has been demonstrated
Robert V Rouse MD
Department of Pathology
Stanford University School of Medicine
Stanford CA 94305-5342
Original posting/updates : 10/7/10
