Application of the Milan System for Reporting Salivary Gland Cytopathology with Histopathological Correlation

Abstract

Background: Fine-needle aspiration (FNA) is widely accepted as an efficient first line diagnostic of salivary gland lesions.Intratumoral heterogeneity and morphological overlap existing between salivary gland tumors makes it rigorous andchallenging in the diagnosis by FNA. The Milan System for Reporting Salivary Gland Cytopathology (TMSRSGC) is a tieredrisk-stratification scheme designed to standardize reporting and facilitate decision making. The objective of this study is toevaluate the efficacy of The Milan system for reporting salivary gland cytopathology with histopathological correlation.Method: A prospective study of salivary gland cytology was performed over a 1-year period at Department of PathologyBPKIHS. Cases were categorized as per the MSRSGC and histopathological correlation was obtained. The risk ofmalignancy were calculated for all diagnostic categories.Result: A total of 30 salivary gland cytology with histopathological follow up were evaluated. FNA had a sensitivity,specificity, diagnostic accuracy, PPV and NPV of 72.7%, 100%, 88.88%, 100% and 84.2% respectively. Good agreementwas seen between cytological and histopathological diagnosis.Conclusion: The Milan System for Reporting Salivary Gland Cytopathology provides an effective standardizeddiagnostic framework which aids in better clinicopathological communication and improves the quality, clarity as well asreproducibility of cytological diagnosis of salivary gland lesions.