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Evaluation of Accuracy of Milan System for Reporting Salivary Gland Cytology: Review of Morphology and Diagnostic Challenges in Each Category

BACKGROUND: Fine-needle aspiration cytology (FNAC) in salivary gland lesions is challenging for the cytopathologists due to diverse morphological pattern and overlapping morphologic features which are responsible for the pitfalls. The present study was conducted to evaluate the efficacy of the Milan...

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Autores principales: Amita, K, Rakshitha, HB, Singh, Avinash, Shankar, S Vijay
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947732/
https://www.ncbi.nlm.nih.gov/pubmed/31942093
http://dx.doi.org/10.4103/JOC.JOC_191_18
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author Amita, K
Rakshitha, HB
Singh, Avinash
Shankar, S Vijay
author_facet Amita, K
Rakshitha, HB
Singh, Avinash
Shankar, S Vijay
author_sort Amita, K
collection PubMed
description BACKGROUND: Fine-needle aspiration cytology (FNAC) in salivary gland lesions is challenging for the cytopathologists due to diverse morphological pattern and overlapping morphologic features which are responsible for the pitfalls. The present study was conducted to evaluate the efficacy of the Milan system in the diagnosis of salivary gland lesions and to discuss and review the morphology and diagnostic challenges in individual Milan categories. MATERIALS AND METHODS: The study was a retrospective diagnostic analytical study in the department of pathology at a tertiary care hospital attached to medical college over a duration of 2 years. All the salivary gland FNAC cases were reviewed and divided into six categories as per the proposed Milan system for reporting salivary gland cytopathology. Histopathology correlation was performed wherever possible. RESULTS: A total of 131 cases formed the study group. The number of cases in each category were: nondiagnostic 4.5%, nonneoplastic 51.9%, atypical lesions 0.76%, neoplastic category benign neoplasm 21.37%, salivary lesion of uncertain malignant potential 1.52%, suspicious category 2.29%, and malignant category 17.5%. The risk of malignancy for each categories were 6.25% (nonneoplastic), 100% (atypical), 3.3% (neoplastic), 0% (benign), 25% (salivary neoplasm of uncertain neoplastic potential), 100% (suspicious for malignancy), and 100% (malignant) categories. Sensitivity, specificity, positive predictive value, and negative predictive value of FNAC with application of Milan system was 89.4%, 100%, 100%, and 95.74%, respectively. CONCLUSION: The high efficacy of FNAC obtained in the present study, when Milan system was applied, confirms the usefulness of this scheme in reporting salivary gland lesions.
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spelling pubmed-69477322020-01-15 Evaluation of Accuracy of Milan System for Reporting Salivary Gland Cytology: Review of Morphology and Diagnostic Challenges in Each Category Amita, K Rakshitha, HB Singh, Avinash Shankar, S Vijay J Cytol Original Article BACKGROUND: Fine-needle aspiration cytology (FNAC) in salivary gland lesions is challenging for the cytopathologists due to diverse morphological pattern and overlapping morphologic features which are responsible for the pitfalls. The present study was conducted to evaluate the efficacy of the Milan system in the diagnosis of salivary gland lesions and to discuss and review the morphology and diagnostic challenges in individual Milan categories. MATERIALS AND METHODS: The study was a retrospective diagnostic analytical study in the department of pathology at a tertiary care hospital attached to medical college over a duration of 2 years. All the salivary gland FNAC cases were reviewed and divided into six categories as per the proposed Milan system for reporting salivary gland cytopathology. Histopathology correlation was performed wherever possible. RESULTS: A total of 131 cases formed the study group. The number of cases in each category were: nondiagnostic 4.5%, nonneoplastic 51.9%, atypical lesions 0.76%, neoplastic category benign neoplasm 21.37%, salivary lesion of uncertain malignant potential 1.52%, suspicious category 2.29%, and malignant category 17.5%. The risk of malignancy for each categories were 6.25% (nonneoplastic), 100% (atypical), 3.3% (neoplastic), 0% (benign), 25% (salivary neoplasm of uncertain neoplastic potential), 100% (suspicious for malignancy), and 100% (malignant) categories. Sensitivity, specificity, positive predictive value, and negative predictive value of FNAC with application of Milan system was 89.4%, 100%, 100%, and 95.74%, respectively. CONCLUSION: The high efficacy of FNAC obtained in the present study, when Milan system was applied, confirms the usefulness of this scheme in reporting salivary gland lesions. Wolters Kluwer - Medknow 2020 2019-12-23 /pmc/articles/PMC6947732/ /pubmed/31942093 http://dx.doi.org/10.4103/JOC.JOC_191_18 Text en Copyright: © 2019 Journal of Cytology http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Amita, K
Rakshitha, HB
Singh, Avinash
Shankar, S Vijay
Evaluation of Accuracy of Milan System for Reporting Salivary Gland Cytology: Review of Morphology and Diagnostic Challenges in Each Category
title Evaluation of Accuracy of Milan System for Reporting Salivary Gland Cytology: Review of Morphology and Diagnostic Challenges in Each Category
title_full Evaluation of Accuracy of Milan System for Reporting Salivary Gland Cytology: Review of Morphology and Diagnostic Challenges in Each Category
title_fullStr Evaluation of Accuracy of Milan System for Reporting Salivary Gland Cytology: Review of Morphology and Diagnostic Challenges in Each Category
title_full_unstemmed Evaluation of Accuracy of Milan System for Reporting Salivary Gland Cytology: Review of Morphology and Diagnostic Challenges in Each Category
title_short Evaluation of Accuracy of Milan System for Reporting Salivary Gland Cytology: Review of Morphology and Diagnostic Challenges in Each Category
title_sort evaluation of accuracy of milan system for reporting salivary gland cytology: review of morphology and diagnostic challenges in each category
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6947732/
https://www.ncbi.nlm.nih.gov/pubmed/31942093
http://dx.doi.org/10.4103/JOC.JOC_191_18
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