Reporting Risk of Malignancy in Salivary Gland Cytopathology and Histopathology: A Cross-sectional Study

Abstract

Introduction: For preoperative evaluation of patient with salivary gland lesion Fine Needle Aspiration Cytology (FNAC) is an effective technique, but due to lack of uniform system for reporting and also because of morphological heterogeneity and overlap between different lesions there are limitations, in its use. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) was introduced which divides salivary gland lesions into six categories, guides in diagnosis and further management of Risk Of Malignancy (ROM) in different categories. Aim: The aim of the study was to classify salivary gland lesions according to MSRSGC and also evaluate for ROM in each category. Materials and Methods: This was a cross-sectional study looking at the data over a period of 3 years (2017 Jan to Dec 2019) in the Department of Pathology Chirayu Medical College and Hospital Bhopal. In this study salivary gland FNAC cases were categorised according to Milan System on cytopathology. Results: A total of 63 cases of salivary gland system FNAC were evaluated on cytology and classified according to MILAN system. Histopathological follow-up (correlation) was available in 47 cases. The risk of malignancy (ROM) in different categories was calculated. Category I Nondiagnostic constituted 25%, Category II Non-neoplastic comprised 0%, Category III Atypia of Undetermined Significance (AUS) showed 50% Category IV: (a) Benign showed 5.0% IV; (b) Salivary gland neoplasm of Uncertain Malignant Potential (SUMP) comprised 100%, Category V Suspicious for Malignancy (SM) comprised 100% and Category VI Malignant constituted 90%. Conclusion: MSRSGC is an evidence based effective system for salivary gland FNAC. It provides better communication with clinicians and improves over all patient care.