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Utility of the Milan system for reporting salivary gland cytopathology: A retrospective 5 years study
Author(s) -
Chirmade Jyoti,
Kothari Kanchan,
Naik Leena,
Agnihotri Mona
Publication year - 2021
Publication title -
diagnostic cytopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.417
H-Index - 65
eISSN - 1097-0339
pISSN - 8755-1039
DOI - 10.1002/dc.24697
Subject(s) - cytopathology , medicine , malignancy , atypia , salivary gland , cytology , histopathology , pathology , retrospective cohort study , neoplasm , fine needle aspiration , radiology , biopsy
Background Fine‐needle aspiration cytology (FNAC) is an established technique for preoperative diagnosis of salivary gland lesions; however, lack of a uniform reporting system has been a handicap. The main aims of this study were to evaluate the utility of the – “The Milan System for Reporting Salivary Gland Cytopathology” (MSRSGC) and ascertain the risk of malignancy (ROM) for each category. Methods All salivary gland FNACs over 5 years (January 2014‐December 2018) were reviewed and assigned a diagnostic category from the MSRSGC. Clinical data were taken from Cytology records. Cytodiagnosis was correlated with histopathology wherever available and ROM was calculated. Results A total of 120 salivary gland FNACs were studied. Age ranged between 5 and 85 years, male:female ratio was 2:1 and parotid was the commonest gland aspirated. Cases were reclassified as I non‐diagnostic (2.5%), II non‐neoplastic (15%), III atypia of uncertain significance‐AUS (1.7%), IV A neoplasm benign (50%), IV B neoplasm of uncertain malignant potential (12.5%), V suspicious for malignancy (5%), and VI malignant (13.3%). Follow‐up was available in 70 (58.3%) cases. The sensitivity, specificity, negative predictive value, and positive predictive value were 92.3%, 100%, 100%, and 98.27% respectively. ROM was non‐neoplastic (0%), AUS (50%), neoplasm benign (0%), neoplasm of uncertain malignant potential (28.6%), suspicious for malignancy (100%), and malignant (100%). Conclusion Salivary gland FNAC is a reliable diagnostic tool and the “Milan system” will further increase FNA reliability, help risk stratification, and improve patient care.

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