{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T12:40:18Z","timestamp":1793882418884,"version":"4.7.0"},"reference-count":40,"publisher":"Oxford University Press (OUP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2010,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>We performed a histologic and immunohistochemical assessment of 53 noninvasive appendiceal epithelial proliferations, appropriating terminology and using markers shown useful in differentiating serrated colorectal polyps. These were classified as hyperplastic polyp (HP), sessile serrated adenoma (SSA), mixed serrated and adenomatous lesion (MSAL), mucinous cystadenoma (MCA), or conventional adenoma (CAD). Immunohistochemical analysis for cytokeratin (CK) 20, Ki-67, MUC6, and \u03b2-catenin was performed. Diagnoses were as follows: HP, 6; SSA, 12; HP vs SSA, 3; MSAL, 16; MCA, 14; and CAD, 2. All HPs showed expanded (beyond surface) CK20 and expanded or normal (base) Ki-67; 1 was MUC6+. Most SSAs and MSALs were CK20-expanded or expanded with random expression in deep crypts (Ex\/I) and Ki-67-expanded, Ex\/I (expanded with asymmetry), or normal. All SSAs and 8 of 16 MSALs were MUC6+. CADs were CK20-Ex\/I, Ki-67-Ex, and MUC6\u2013; 1 showed nuclear \u03b2-catenin expression. Serrated appendiceal lesions can be categorized using colorectal terminology. MUC6 is associated with SSA morphologic features. Similar immunohistochemical patterns in SSA and MSAL suggest a link between these lesions.<\/jats:p>","DOI":"10.1309\/ajcp1ujpx6uurlch","type":"journal-article","created":{"date-parts":[[2010,3,15]],"date-time":"2010-03-15T20:22:04Z","timestamp":1268684524000},"page":"623-632","source":"Crossref","is-referenced-by-count":27,"title":["Serrated Lesions of the Appendix"],"prefix":"10.1093","volume":"133","author":[{"given":"Andrew M.","family":"Bellizzi","sequence":"first","affiliation":[{"name":"1Departments of Pathology, Brigham and Women\u2019s Hospital, Boston, MA"},{"name":"2The Ohio State University Medical Center, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Rock","sequence":"additional","affiliation":[{"name":"2The Ohio State University Medical Center, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William L.","family":"Marsh","sequence":"additional","affiliation":[{"name":"2The Ohio State University Medical Center, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wendy L.","family":"Frankel","sequence":"additional","affiliation":[{"name":"2The Ohio State University Medical Center, Columbus"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2010,4,1]]},"reference":[{"key":"2023011906292700600_b1-1330623","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1097\/00000478-199006000-00003","article-title":"Mixed hyperplastic adenomatous polyps\/serrated adenomas: a distinct form of colorectal neoplasia","volume":"14","author":"Longacre","year":"1990","journal-title":"Am J Surg Pathol"},{"key":"2023011906292700600_b2-1330623","doi-asserted-by":"crossref","first-page":"812","DOI":"10.1126\/science.8484121","article-title":"Clues to the pathogenesis of familial colorectal cancer","volume":"260","author":"Aaltonen","year":"1993","journal-title":"Science"},{"key":"2023011906292700600_b3-1330623","doi-asserted-by":"crossref","first-page":"8681","DOI":"10.1073\/pnas.96.15.8681","article-title":"CpG island methylator phenotype in colorectal cancer","volume":"96","author":"Toyota","year":"1999","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2023011906292700600_b4-1330623","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.1093\/jnci\/93.17.1307","article-title":"Sporadic colorectal cancers with microsatellite instability and their possible origin in hyperplastic polyps and serrated adenomas","volume":"93","author":"Hawkins","year":"2001","journal-title":"J Natl Cancer Inst"},{"key":"2023011906292700600_b5-1330623","doi-asserted-by":"crossref","first-page":"778","DOI":"10.1309\/DRFQ0WFUF1G13CTK","article-title":"Hyperplastic-like colon polyps that preceded microsatellite-unstable adenocarcinomas","volume":"119","author":"Goldstein","year":"2003","journal-title":"Am J Clin Pathol"},{"key":"2023011906292700600_b6-1330623","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/00000478-200301000-00008","article-title":"Morphologic reappraisal of serrated colorectal polyps","volume":"27","author":"Torlakovic","year":"2003","journal-title":"Am J Surg Pathol"},{"key":"2023011906292700600_b7-1330623","doi-asserted-by":"crossref","first-page":"1452","DOI":"10.1097\/01.pas.0000141404.56839.6a","article-title":"BRAF and KRAS mutations in hyperplastic polyps and serrated adenomas of the colorectum: relationship to histology and CpG island methylation status","volume":"28","author":"Yang","year":"2004","journal-title":"Am J Surg Pathol"},{"key":"2023011906292700600_b8-1330623","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1309\/V2EPTPLJRB3FGHJL","article-title":"Serrated polyps of the large intestine: a morphologic and molecular review of an evolving concept","volume":"124","author":"Snover","year":"2005","journal-title":"Am J Clin Pathol"},{"key":"2023011906292700600_b9-1330623","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1053\/j.gastro.2006.08.038","article-title":"High prevalence of sessile serrated adenomas with BRAF mutations: a prospective study of patients undergoing colonoscopy","volume":"131","author":"Spring","year":"2006","journal-title":"Gastroenterology"},{"key":"2023011906292700600_b10-1330623","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1097\/01.pas.0000213313.36306.85","article-title":"Comparison of microsatellite instability, CpG island methylation phenotype, BRAF and KRAS status in serrated polyps and traditional adenomas indicates separate pathways to distinct colorectal carcinoma end points","volume":"30","author":"O\u2019Brien","year":"2006","journal-title":"Am J Surg Pathol"},{"key":"2023011906292700600_b11-1330623","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1136\/jcp.52.1.5","article-title":"DNA microsatellite instability in hyperplastic polyps, serrated adenomas, and mixed polyps: a mild mutator pathway for colorectal cancer?","volume":"52","author":"Iino","year":"1999","journal-title":"J Clin Pathol"},{"key":"2023011906292700600_b12-1330623","first-page":"827","article-title":"Methylation of O-6-methylguanine DNA methyltransferase characterizes a subset of colorectal cancer with low-level DNA microsatellite instability","volume":"61","author":"Whitehall","year":"2001","journal-title":"Cancer Res"},{"key":"2023011906292700600_b13-1330623","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1136\/jcp.25.9.809","article-title":"Mucosal metaplasia in the appendix","volume":"25","author":"MacGillivray","year":"1972","journal-title":"J Clin Pathol"},{"key":"2023011906292700600_b14-1330623","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1002\/1097-0142(197312)32:6<1525::AID-CNCR2820320632>3.0.CO;2-C","article-title":"Mucosal hyperplasia, mucinous cystadenoma, and mucinous cystadenocarcinoma of the appendix: a re-evaluation of appendiceal \u201cmucocele.\u201d","volume":"32","author":"Higa","year":"1973","journal-title":"Cancer"},{"key":"2023011906292700600_b15-1330623","first-page":"385","article-title":"Hyperplastic (metaplastic) polyps of the appendix: report of 19 cases","volume":"97","author":"Qizilbash","year":"1974","journal-title":"Arch Pathol"},{"key":"2023011906292700600_b16-1330623","doi-asserted-by":"crossref","first-page":"447","DOI":"10.1111\/j.1365-2559.1992.tb00429.x","article-title":"Benign epithelial neoplasms of the appendix: classification and clinical associations","volume":"21","author":"Williams","year":"1992","journal-title":"Histopathology"},{"key":"2023011906292700600_b17-1330623","doi-asserted-by":"crossref","first-page":"946","DOI":"10.1136\/jcp.2004.018317","article-title":"Serrated adenomas of the appendix","volume":"57","author":"Rubio","year":"2004","journal-title":"J Clin Pathol"},{"key":"2023011906292700600_b18-1330623","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1309\/BF5KLH7J547AXAA0","article-title":"Sessile serrated adenoma is associated with acute appendicitis in patients 30 years or older","volume":"126","author":"Renshaw","year":"2006","journal-title":"Am J Clin Pathol"},{"key":"2023011906292700600_b19-1330623","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1097\/PAS.0b013e318157f002","article-title":"Sessile serrated adenoma (SSA) vs traditional serrated adenoma (TSA)","volume":"32","author":"Torlakovic","year":"2008","journal-title":"Am J Surg Pathol"},{"key":"2023011906292700600_b20-1330623","doi-asserted-by":"crossref","first-page":"660","DOI":"10.1038\/modpathol.2008.55","article-title":"Selective expression of gastric mucin MUC6 in colonic sessile serrated adenoma but not in hyperplastic polyp aids in morphological diagnosis of serrated polyps","volume":"21","author":"Owens","year":"2008","journal-title":"Mod Pathol"},{"key":"2023011906292700600_b21-1330623","doi-asserted-by":"crossref","first-page":"416","DOI":"10.1309\/603UQKM7C2KELGJU","article-title":"Frequent \u03b2-catenin nuclear labeling in sessile serrated polyps of the colorectum with neoplastic potential","volume":"129","author":"Wu","year":"2008","journal-title":"Am J Clin Pathol"},{"key":"2023011906292700600_b22-1330623","doi-asserted-by":"crossref","first-page":"938","DOI":"10.1309\/NXDB6FMTE9X5CD6Y","article-title":"A multinational, Internet-based assessment of observer variability in the diagnosis of serrated colorectal polyps","volume":"127","author":"Glatz","year":"2007","journal-title":"Am J Clin Pathol"},{"key":"2023011906292700600_b23-1330623","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1097\/PAS.0b013e318093e40a","article-title":"Sessile serrated adenoma: challenging discrimination from other serrated colonic polyps","volume":"32","author":"Farris","year":"2008","journal-title":"Am J Surg Pathol"},{"key":"2023011906292700600_b24-1330623","doi-asserted-by":"crossref","first-page":"757","DOI":"10.1002\/1097-0142(19950201)75:3<757::AID-CNCR2820750303>3.0.CO;2-F","article-title":"Epithelial noncarcinoid tumors and tumor-like lesions of the appendix: a clinicopathologic study of 184 patients with a multivariate analysis of prognostic factors","volume":"75","author":"Carr","year":"1995","journal-title":"Cancer"},{"key":"2023011906292700600_b25-1330623","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1053\/j.semdp.2004.11.005","article-title":"Primary epithelial neoplasms and other epithelial lesions of the appendix (excluding carcinoid tumors)","volume":"21","author":"Misdraji","year":"2004","journal-title":"Semin Diagn Pathol"},{"key":"2023011906292700600_b26-1330623","doi-asserted-by":"crossref","first-page":"1039","DOI":"10.1177\/002215549904700808","article-title":"Immunohistochemical staining patterns of MUC1, MUC2, MUC4, and MUC5AC mucins in hyperplastic polyps, serrated adenomas, and traditional adenomas of the colorectum","volume":"47","author":"Biemer-Huttmann","year":"1999","journal-title":"J Histochem Cytochem"},{"key":"2023011906292700600_b27-1330623","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1111\/j.1440-1827.2004.01639.x","article-title":"Bidirectional gastric differentiation in cellular mucin phenotype (foveolar and pyloric) in serrated adenoma and hyperplastic polyp of the colorectum","volume":"54","author":"Hirono","year":"2004","journal-title":"Pathol Int"},{"key":"2023011906292700600_b28-1330623","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1007\/s00418-007-0326-2","article-title":"Hyperplastic polyps and sessile serrated \u201cadenomas\u201d of the colon and rectum display gastric pyloric differentiation","volume":"128","author":"Mochizuka","year":"2007","journal-title":"Histochem Cell Biol"},{"key":"2023011906292700600_b29-1330623","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.cell.2006.10.018","article-title":"Wnt\/beta-catenin signaling in development and disease","volume":"127","author":"Clevers","year":"2006","journal-title":"Cell"},{"key":"2023011906292700600_b30-1330623","doi-asserted-by":"crossref","first-page":"1742","DOI":"10.1097\/PAS.0b013e31806bee6d","article-title":"A comprehensive study of nondysplastic and dysplastic serrated polyps of the vermiform appendix","volume":"31","author":"Yantiss","year":"2007","journal-title":"Am J Surg Pathol"},{"key":"2023011906292700600_b31-1330623","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1038\/modpathol.3880572","article-title":"Mucinous and nonmucinous appendiceal adenocarcinomas: different clinicopathological features but similar genetic alterations","volume":"15","author":"Kabbani","year":"2002","journal-title":"Mod Pathol"},{"key":"2023011906292700600_b32-1330623","doi-asserted-by":"crossref","first-page":"1447","DOI":"10.1038\/modpathol.3800212","article-title":"Defective mismatch repair in the pathogenesis of low-grade appendiceal mucinous neoplasms and adenocarcinomas","volume":"17","author":"Misdraji","year":"2004","journal-title":"Mod Pathol"},{"issue":"suppl 2","key":"2023011906292700600_b33-1330623","first-page":"127A","article-title":"Expression of mismatch repair proteins, O(6)-methylguanine-DNA methyltransferase (MGMT), B-catenin and p53 in appendiceal adenocarcinomas [abstract]","volume":"20","author":"Pham","year":"2007","journal-title":"Mod Pathol"},{"key":"2023011906292700600_b34-1330623","doi-asserted-by":"crossref","first-page":"415","DOI":"10.1097\/00000478-199105000-00001","article-title":"Mucinous tumors of the appendix associated with mucinous tumors of the ovary and pseudomyxoma peritonei: a clinicopathological analysis of 22 cases supporting an origin in the appendix","volume":"15","author":"Young","year":"1991","journal-title":"Am J Surg Pathol"},{"key":"2023011906292700600_b35-1330623","first-page":"591","article-title":"Pseudomyxoma peritonei: a clinicopathologic study of 19 cases with emphasis on site of origin and nature of associated ovarian tumors","volume":"18","author":"Prayson","year":"1994","journal-title":"Am J Surg Pathol"},{"key":"2023011906292700600_b36-1330623","doi-asserted-by":"crossref","first-page":"1390","DOI":"10.1097\/00000478-199512000-00006","article-title":"Disseminated peritoneal adenomucinosis and peritoneal mucinous carcinomatosis: a clinicopathologic analysis of 109 cases with emphasis on distinguishing pathologic features, site of origin, prognosis, and relationship to \u201cpseudomyxoma peritonei.\u201d","volume":"19","author":"Ronnett","year":"1995","journal-title":"Am J Surg Pathol"},{"key":"2023011906292700600_b37-1330623","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1097\/01.pap.0000194625.05137.51","article-title":"Appendiceal mucinous tumors and pseudomyxoma peritonei: histologic features, diagnostic problems, and proposed classification","volume":"12","author":"Pai","year":"2005","journal-title":"Adv Anat Pathol"},{"key":"2023011906292700600_b38-1330623","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1038\/sj.onc.1207194","article-title":"Loss of chromosome 18q and DPC4 (Smad4) mutations in appendiceal adenocarcinomas","volume":"23","author":"Maru","year":"2004","journal-title":"Oncogene"},{"key":"2023011906292700600_b39-1330623","doi-asserted-by":"crossref","first-page":"1610","DOI":"10.1245\/s10434-006-9081-1","article-title":"Analysis of loss of heterozygosity for tumor-suppressor genes can accurately classify and predict the clinical behavior of mucinous tumors arising from the appendix","volume":"13","author":"Maheshwari","year":"2006","journal-title":"Ann Surg Oncol"},{"key":"2023011906292700600_b40-1330623","doi-asserted-by":"crossref","first-page":"682","DOI":"10.1136\/jcp.2003.015230","article-title":"My approach to serrated polyps of the colorectum","volume":"57","author":"Higuchi","year":"2004","journal-title":"J Clin Pathol"}],"container-title":["American Journal of Clinical Pathology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/133\/4\/623\/48763621\/ajcp_133_4_623.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajcp\/article-pdf\/133\/4\/623\/48763621\/ajcp_133_4_623.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,19]],"date-time":"2023-01-19T06:30:14Z","timestamp":1674109814000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajcp\/article\/133\/4\/623\/1761120"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,4,1]]},"references-count":40,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2010,4,1]]},"published-print":{"date-parts":[[2010,4,1]]}},"URL":"https:\/\/doi.org\/10.1309\/ajcp1ujpx6uurlch","relation":{},"ISSN":["1943-7722","0002-9173"],"issn-type":[{"value":"1943-7722","type":"electronic"},{"value":"0002-9173","type":"print"}],"subject":[],"published-other":{"date-parts":[[2010,4,1]]},"published":{"date-parts":[[2010,4,1]]}}}