Benign tumors
Serrated polyps

Topic Completed: 1 July 2017

Revised: 20 August 2019

Copyright: (c) 2003-2019,, Inc.

PubMed Search: Appendix serrated polyps

Michael Feely, D.O.
Raul S. Gonzalez, M.D.
Page views in 2018: 2,619
Page views in 2019 to date: 2,711
Cite this page: Feely M, Gonzalez RS. Serrated polyps. website. Accessed September 22nd, 2019.
Definition / general
  • Benign serrated lesion of the appendix
Essential features
  • Benign appendix polyp that may show cytologic atypia / dysplasia
  • Harbors KRAS mutations
  • "Serrated polyp" is currently preferred terminology over "sessile serrated adenoma / polyp," as appendiceal lesions appear to have different mutations than similar lesions in the colon (Am J Surg Pathol 2016;40:14)
  • Presence or absence of dysplasia should be noted
Clinical features
  • Typically an incidental finding at the time of appendectomy
Microscopic (histologic) description
  • Localized serrated epithelial lesion within the luminal appendix, with retention of the muscularis mucosae
  • Often circumferential
  • Typically minimal to no nuclear atypia, though visible cytologic dysplasia (low grade or high grade) may sometimes be present
Microscopic (histologic) images

Contributed by Michael Feely, D.O.
Missing Image

Serrated polyp of appendix

Molecular / cytogenetics description
Differential diagnosis
Additional references
Board review question #1
    Serrated polyp of the appendix differs from sessile serrated polyp / adenoma of the colon in what way?

  1. It favors KRAS mutation over BRAF mutation
  2. It has a higher incidence
  3. It never shows cytologic atypia
  4. It only occurs in patients with Lynch syndrome
  5. It rarely loses MLH1 by immunohistochemistry
Board review answer #1
A. It favors KRAS mutation over BRAF mutation

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