The key distinguishing features of serrated adenocarcinomas23
| Subtype | Detailed appearances |
|---|---|
| Serrated | Well-moderately differentiated glands in which the epithelium has a serrated appearance Eosinophilic cytoplasm—may be intense* Vesicular (open chromatin) nuclei with basal location* Dirty necrosis focal or absent May possess small areas of mucinous differentiation |
| Mucinous | The neoplastic cells are present usually as (poorly differentiated) cords of cells floating within the mucus pools ‘Serrated cytology’ retained Areas with a ‘serrated morphology’ can form up to 50% of the tumour |
| Trabecular | Poorly differentiated clusters and cords of neoplastic epithelial cells ‘Serrated cytology’ maintained Lymphatic invasion common This pattern may be seen at the advancing edge of serrated adenocarcinomas that are otherwise one of the other two subtypes |
*‘Serrated cytology’ refers to the combination of these nuclear and cytoplasmic features.