{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T16:01:14Z","timestamp":1783094474459,"version":"3.54.6"},"reference-count":19,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2017,5,5]],"date-time":"2017-05-05T00:00:00Z","timestamp":1493942400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Histopathology"],"published-print":{"date-parts":[[2017,8]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>Traditional serrated adenomas (<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>s) account for 5% of serrated polyps, and have a villiform architecture, eosinophilic cells with a brush border, and indented, flat\u2010topped luminal serrations. However, some are composed of mucin\u2010filled goblet cells (<jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>s): mucin\u2010rich <jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content> (Mr<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>). The aim of this study was to determine whether this variant has unique features as compared with classic <jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">cTSA<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>One hundred and fifty\u2010six <jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>s were retrieved from the period 2010\u20132016. Patient demographics, site of polyps and 16 microscopic variables were evaluated. <jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>s containing \u226550% <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>s were classified as Mr<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>s. Ectopic crypt foci (<jats:styled-content style=\"fixed-case\">ECF<\/jats:styled-content>s) were quantified as low (1\u201310) or high (&gt;10), counted at \u00d7200 magnification, and the average was taken for 10 fields. Twenty\u2010four fulfilled the criteria for Mr<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>. In males, Mr<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>s (65%) were more prevalent than <jats:styled-content style=\"fixed-case\">cTSA<\/jats:styled-content>s (55%). There was no age difference, and both variants had a predilection for the left colon, although, in the right colon, Mr<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>s were more frequent (39%) than <jats:styled-content style=\"fixed-case\">cTSA<\/jats:styled-content>s (10%) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.012). Adenomatous dysplasia was present in four of 24 Mr<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>s (low grade, 3; high grade, 1). The most distinctive features of Mr<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>s were: a variable growth pattern [endophytic (9%), mixed (30%), or villiform\/exophytic (61%)], and a lower frequency of <jats:styled-content style=\"fixed-case\">ECF<\/jats:styled-content>s\u00a0(<jats:italic>P<\/jats:italic>\u00a0=\u00a00.001) and more intraepithelial lymphocytes (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.05) than in <jats:styled-content style=\"fixed-case\">cTSA<\/jats:styled-content>s. Mr<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>s retain characteristic luminal serrations, at least focally. Inflamed Mr<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content>s can mimic inflammatory polyps and hamartomatous polyps (when there are &gt;95% GCs).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Mr<jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content> is characterized by &gt;50% <jats:styled-content style=\"fixed-case\">GC<\/jats:styled-content>s, and fewer <jats:styled-content style=\"fixed-case\">ECF<\/jats:styled-content>s than <jats:styled-content style=\"fixed-case\">cTSA<\/jats:styled-content>, but with preservation of archetypal luminal serrations. Awareness of this variant will prevent misdiagnosis, given the association of <jats:styled-content style=\"fixed-case\">TSA<\/jats:styled-content> with the accelerated pathway to colorectal cancer.<\/jats:p><\/jats:sec>","DOI":"10.1111\/his.13212","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T16:13:40Z","timestamp":1489508020000},"page":"208-216","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Mucin\u2010rich variant of traditional serrated adenoma: a distinct morphological variant"],"prefix":"10.1111","volume":"71","author":[{"given":"Sangeetha","family":"N Kalimuthu","sequence":"first","affiliation":[{"name":"Department of Pathology Laboratory Medicine Program University Health Network University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefano","family":"Serra","sequence":"additional","affiliation":[{"name":"Department of Pathology Laboratory Medicine Program University Health Network University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Hafezi\u2010Bakhtiari","sequence":"additional","affiliation":[{"name":"Department of Pathology Laboratory Medicine Program University Health Network University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Colling","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology Oxford University Hospitals Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lai Mun","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cellular Pathology Oxford University Hospitals Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2124-515X","authenticated-orcid":false,"given":"Runjan","family":"Chetty","sequence":"additional","affiliation":[{"name":"Department of Pathology Laboratory Medicine Program University Health Network University of Toronto Toronto ON Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,5]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2012.161"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2014-202827"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mpdhp.2013.12.005"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.12055"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2015-203452"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-199006000-00003"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000478-200301000-00008"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e318157f002"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/his.12555"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.2014.122"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.humpath.2015.04.002"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0b013e31802d74c0"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1309\/VBAGV3BR96N2EQTR"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1349-7006.1995.tb02465.x"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1309\/AJCPDJC9VC5KTYUS"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.4709"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/path.4741"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrg1840"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature03659"}],"container-title":["Histopathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fhis.13212","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/his.13212","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T10:43:02Z","timestamp":1696243382000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/his.13212"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,5]]},"references-count":19,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2017,8]]}},"alternative-id":["10.1111\/his.13212"],"URL":"https:\/\/doi.org\/10.1111\/his.13212","archive":["Portico"],"relation":{},"ISSN":["0309-0167","1365-2559"],"issn-type":[{"value":"0309-0167","type":"print"},{"value":"1365-2559","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,5]]},"assertion":[{"value":"2016-11-29","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication 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